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Contact Information

NORTHLAND RETINA ASSOC
22250 PROVIDENCE DR
STE 607
SOUTHFIELD, MI48075
 Phone: 248-569-0131
 Fax: 248-569-0132
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for NORTHLAND RETINA ASSOC · (Female)

NPI # 1760586861
Status Active
Credentials
Entity Individual
Enumeration date 09/11/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 4301023890
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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