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NPI Code Detail

MEDICARE: DEANNA J SCHEERENS O.D.

MEDICARE:   DEANNA J SCHEERENS  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist4901003647MI

General Provider Information

NPI Number : 1780766154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA J SCHEERENS O.D.
Provider Business Mailing Address
First Line : PO BOX 427
Second Line : MACKINAW CITY
City : MACKINAW CITY
State : MI
Zip : 49701-0427
Country : US
Telephone Number : 231-436-2020
Fax Number :
Provider Business Practice Location Address
First Line : 580 SOUTH NICOLET STREET
Second Line : MACKINAW CITY
City : MACKINAW CITY
State : MI
Zip : 49701
Country : US
Telephone Number : 231-436-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2006
Last Update Date : 07/09/2007

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Directions to “ DEANNA J SCHEERENS O.D.” Practice Location

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