Healthcare Provider Details

I. General information

NPI: 1073212205
Provider Name (Legal Business Name): MARIE CATHERINE ELCHAER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33100 S GRATIOT AVE
CLINTON TOWNSHIP MI
48035-4036
US

IV. Provider business mailing address

33100 S GRATIOT AVE
CLINTON TOWNSHIP MI
48035-4036
US

V. Phone/Fax

Practice location:
  • Phone: 586-294-0120
  • Fax:
Mailing address:
  • Phone: 248-894-2586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901005659
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: