Organization
CADILLAC EYE CLINIC PC
Active
Organization
CADILLAC EYE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MICHAEL BRENZ MD (PRESIDENT)
(231) 775-1248
Entity
Organization
Contact information
Practice address
502 COBB ST, CADILLAC, MI 49601-2577
(231) 775-1248
(231) 775-1156
Mailing address
502 COBBS ST, CADILLAC, MI 49601-2577
(231) 775-1248
(231) 775-1156
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180H34653
BCBSM
MI
05
—
3255157
—
MI
Enumeration date
12/13/2005
Last updated
04/22/2010
Update your record
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