Healthcare Provider Details

I. General information

NPI: 1265455208
Provider Name (Legal Business Name): EFTHEMIOS RAPHTIS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 W. UNIVERSITY DR.
ROCHESTER MI
48307
US

IV. Provider business mailing address

432 W. UNIVERSITY DR.
ROCHESTER MI
48307
US

V. Phone/Fax

Practice location:
  • Phone: 248-651-6122
  • Fax: 248-651-4825
Mailing address:
  • Phone: 248-651-6122
  • Fax: 248-651-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: HELEN ARETAKIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 248-651-6122