CHILDREN'S EYE CARE PC (NPI# 1972874683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972874683 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S EYE CARE PC |
| Practice Address |
3901 Beaubien St Detroit MI 48201-2119 |
| Mailing Address |
6689 Orchard Lake Road #297 West Bloomfield MI 48322-3009 |
| Practice Telephone | 3137453937 |
| Practice Fax Number | 3137450401 |
| Mailing Telephone | 2482548140 |
| Mailing Fax Number | 2482548150 |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2020-04-20 |
| Authorized Official Name | TRACI FRITZ (PRACTICE MANAGER) |
| Authorized Official Telephone | 2482548140 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207WX0110X |
Ophthalmology Specialization: Pediatric Ophthalmology and Strabismus Specialist |
Allopathic & Osteopathic Physicians | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1534388 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922350214 | Children's Eye Care PC | Optometrist | 42700 Garfield, Ste 200, Clinton Twp, MI 48038 | 2012-10-10 |
| Street Address |
3901 BEAUBIEN ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151238 | Mark Campbell | Nurse Anesthetist, Certified Registered | 3901 Beaubien St, Detroit, MI 48201-2119 | 2005-08-18 |
| 1164037735 | Mamdouh Dakhel A Alahmadi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-09-10 |
| 1801407119 | Samantha Mulkiten | Nurse Practitioner | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-08-11 |
| 1346864550 | Mariane Tomiyoshi Asato | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-06-03 |
| 1629691613 | Abigail Marie Troy | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-05-25 |
| 1235750373 | Katherine Marie Obudzinski | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-04-29 |
| 1548880073 | Sara Mercedes Evans | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1619597069 | Zahur Fatima Sallman | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1154941706 | Saira Tariq | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| 1063032688 | Michael Allen Finkel | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780779678 | Otis B. Ferguson IIi Md PC | Ophthalmology | 7633 East Jefferson, Suite 120, Detroit, MI 48214 | 2006-10-04 |
| 1912008566 | Dennis C Woods Sr. | Ophthalmology | 4727 St Antoine St, Suite 207, Detroit, MI 48201 | 2006-09-26 |
| 1689685976 | Associated Eye Institutes of Detroit, PC | Ophthalmology | 65 Cadillac Sq, Ste 105, Detroit, MI 48226-2844 | 2006-08-11 |
| 1245248129 | W Anthony Greer | Ophthalmology | 7733 East Jefferson, Detroit, MI 48214 | 2006-08-04 |
| 1952348443 | Gabriel Sosne | Ophthalmology | 4717 St Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2006-06-01 |
| 1609813120 | Anju Goyal | Ophthalmology | Kresge Eye Institute, 4717 St Antoine, Detroit, MI 48201 | 2006-06-01 |
| 1053388074 | William Robert Lucas Jr. | Ophthalmology | 4717 Saint Antoine St, Kresge Eye Institute, Detroit, MI 48201-1423 | 2006-03-08 |
| 1932185089 | Evan H Black | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2005-12-21 |
| 1033104773 | Daniel Seth Zuckerbrod | Ophthalmology | 14400 West Mcnichols, Detroit, MI 48235-3916 | 2005-09-20 |
| 1235796780 | John Michael Guest | Ophthalmology | 4717 Saint Antoine St, Detroit, MI 48201-1423 | 2019-05-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.