Individual
DR. MAX D GOTTESMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6523 TELEGRAPH RD, BLOOMFIELD HILLS, MI 48301-3066
(248) 593-9955
(248) 593-9966
Mailing address
6523 TELEGRAPH RD, BLOOMFIELD HILLS, MI 48301-3066
(248) 593-9955
(248) 593-9966
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002384
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F37720
MEDICARE PTAN
—
05
—
1972581551
—
MI
05
—
2721213
—
MI
05
—
2721222
—
MI
01
—
MG002384
BLUE CROSS
MI
Enumeration date
01/04/2006
Last updated
05/16/2016
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