MEDICARE: PAUL C. USLAN, OD, PC

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
1	152W00000X	Optometrist	4901002402	MI

General Provider Information

NPI Number	:	1922249978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL C. USLAN, OD, PC

Provider Business Mailing Address
First Line	:	1528 N MAPLE RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-2412
Country	:	US
Telephone Number	:	734-769-1222
Fax Number	:	734-769-1223

Provider Business Practice Location Address
First Line	:	1528 N MAPLE RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-2412
Country	:	US
Telephone Number	:	734-769-1222
Fax Number	:	734-769-1223

Authorized Official
Title or Position	:	PRES
Name	:	DR. PAUL C USLAN
Credential	:	OD
Telephone Number	:	734-769-1222

Provider Enumeration Date	:	03/19/2009
Last Update Date	:	03/30/2009

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