Healthcare Provider Details

I. General information

NPI: 1992715247
Provider Name (Legal Business Name): PATRICK M VERB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11441 E 12 MILE RD
WARREN MI
48093-2639
US

IV. Provider business mailing address

33080 UTICA RD
FRASER MI
48026-2038
US

V. Phone/Fax

Practice location:
  • Phone: 586-756-5060
  • Fax: 586-596-9783
Mailing address:
  • Phone: 586-296-7250
  • Fax: 586-296-7256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberPV033783
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: