Organization
LIVONIA OPHTHALMOLOGISTS PC
Active
Other names
LIVONIA OPHTHALMOLOGISTS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY R LUPOVITCH M.D. (DIRECTOR OFFICER)
(734) 522-0800
Entity
Organization
Contact information
Practice address
29927 6 MILE RD, LIVONIA, MI 48152-3670
(734) 522-0800
(734) 522-1236
Mailing address
29927 6 MILE RD, LIVONIA, MI 48152-3670
(734) 522-0800
(734) 522-1236
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0820689
MR ADVANTAGE
MI
01
—
540Q208880
BLUE CROSS VISION
MI
01
—
C0GXQ
BC SUBMITTER ID
MI
01
—
OH24256
BLUE CROSS GROUP
MI
Enumeration date
03/14/2007
Last updated
10/25/2021
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