Provider Demographics
NPI:1063725919
Name:HITZELBURGER, ERIN NOEL (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:NOEL
Last Name:HITZELBURGER
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44987 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1141
Mailing Address - Country:US
Mailing Address - Phone:586-247-5910
Mailing Address - Fax:586-247-5920
Practice Address - Street 1:32600 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-1126
Practice Address - Country:US
Practice Address - Phone:586-294-0120
Practice Address - Fax:586-294-6623
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004565152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E47602OtherBLUE CROSS
MI0E47602OtherBLUE CROSS