Provider Demographics
NPI:1194798546
Name:CATARACT AND EYE CONSULTANTS OF MI PC
Entity type:Organization
Organization Name:CATARACT AND EYE CONSULTANTS OF MI PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:MUENK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-575-9081
Mailing Address - Street 1:29753 HOOVER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-8900
Mailing Address - Country:US
Mailing Address - Phone:586-573-4333
Mailing Address - Fax:586-573-2149
Practice Address - Street 1:29753 HOOVER RD
Practice Address - Street 2:SUITE A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-8900
Practice Address - Country:US
Practice Address - Phone:586-573-4333
Practice Address - Fax:586-573-2149
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATARACT AND EYE CONSULTANTS OF MI PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-08
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E010410OtherBLUE CROSS BLUE SHIELD MI
MI0384050001Medicare NSC
MIOM21840Medicare PIN