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General NPI Number Information
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NPI Number | 1114249141
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Entity Type | Organization
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Legal Business Name | MICHIGAN OPTOMETRY PC
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 27118 GRATIOT AVE INSIDE COSTCO ROSEVILLE
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City | ROSEVILLE
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State | MI
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Zip | 48066
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Country | US
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Telephone | 586-498-2224
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Fax | 855-852-5529
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Provider Business Mailing Address
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Address Line | 50854 CALVERT ISLE DR
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City | NOVI
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State | MI
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Zip | 48374-2559
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Country | US
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Telephone | 914-522-8273
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEIL BAJAJ
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Credential | OD
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Telephone | 248-747-4496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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