Organization
CHILDRENS EYE CARE PC
Active
Other names
Pediatric Ophthalmology Associate
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ROARTY MD (PRESIDENT)
(313) 561-1777
Entity
Organization
Contact information
Practice address
22731 NEWMAN ST STE 245, DEARBORN, MI 48124-2023
(313) 561-1777
(313) 561-8044
Mailing address
6689 ORCHARD LAKE RD # 297, WEST BLOOMFIELD, MI 48322-3404
(248) 254-8140
(248) 254-8150
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1534388
—
MI
Enumeration date
03/30/2006
Last updated
04/20/2020
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