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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

NPI # 1760586861
LBN Legal business name NORTHLAND RETINA ASSOC
Authorized official FREDERICK HEYNER - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/11/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MI License # 4301023890
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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