Healthcare Provider Details

I. General information

NPI: 1184295982
Provider Name (Legal Business Name): ELIZA MOREY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41555 W TWELVE MILE RD
NOVI MI
48377-3103
US

IV. Provider business mailing address

41555 W TWELVE MILE RD
NOVI MI
48377-3103
US

V. Phone/Fax

Practice location:
  • Phone: 248-675-0800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3710
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6356
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901005639
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: