Healthcare Provider Details

I. General information

NPI: 1447557764
Provider Name (Legal Business Name): CHESTERFIELD EYE CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27903 23 MILE RD
CHESTERFIELD MI
48051-2328
US

IV. Provider business mailing address

8703 26 MILE RD
WASHINGTON MI
48094-2967
US

V. Phone/Fax

Practice location:
  • Phone: 586-598-3937
  • Fax: 586-598-3941
Mailing address:
  • Phone: 586-992-3700
  • Fax: 586-992-3706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. MICHAEL P WEISGERBER
Title or Position: DOCTOR
Credential: OD
Phone: 586-598-3937