Healthcare Provider Details

I. General information

NPI: 1770623431
Provider Name (Legal Business Name): RUHINA KARMALI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33201 VAN DYKE AVE
STERLING HEIGHTS MI
48312-5924
US

IV. Provider business mailing address

50854 CALVERT ISLE DR
NOVI MI
48374-2559
US

V. Phone/Fax

Practice location:
  • Phone: 586-939-8204
  • Fax: 586-939-8282
Mailing address:
  • Phone: 914-522-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901004255
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: