Provider Demographics
NPI:1487672937
Name:PRIEUR, MARC M (OD)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:M
Last Name:PRIEUR
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Gender:M
Credentials:OD
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Mailing Address - Street 1:1825 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2762
Mailing Address - Country:US
Mailing Address - Phone:269-342-0003
Mailing Address - Fax:269-342-4284
Practice Address - Street 1:755 E CHICAGO
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2027
Practice Address - Country:US
Practice Address - Phone:517-278-9004
Practice Address - Fax:269-342-4284
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-05-10
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Provider Licenses
StateLicense IDTaxonomies
MI4901003646152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U50773Medicare UPIN