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General NPI Number Information
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NPI Number | 1023583564
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Entity Type | Organization
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Legal Business Name | ROCHESTER OPHTHALMOLOGY, PLLC
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 1135 W UNIVERSITY DR STE 155
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City | ROCHESTER
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State | MI
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Zip | 48307-1871
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Country | US
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Telephone | 734-277-1578
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Fax |
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Provider Business Mailing Address
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Address Line | 839 CRISPIN
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2467
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Country | US
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Telephone | 734-277-1578
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JOSHUA VRABEC
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Credential | MD
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Telephone | 734-277-1578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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