Healthcare Provider Details

I. General information

NPI: 1598703639
Provider Name (Legal Business Name): RAHMANI EYE INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19727 ALLEN ROAD SUITE 11
BROWNSTONE MI
48183
US

IV. Provider business mailing address

19727 ALLEN ROAD SUITE 11
BROWNSTONE MI
48183
US

V. Phone/Fax

Practice location:
  • Phone: 734-479-4747
  • Fax: 734-479-4774
Mailing address:
  • Phone: 734-479-4747
  • Fax: 734-479-4774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberRR011221
License Number StateMI

VIII. Authorized Official

Name: KANDI BOCK
Title or Position: MEDICAL BILLER
Credential:
Phone: 734-479-4747