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General NPI Number Information
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NPI Number | 1265699516
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Entity Type | Organization
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Legal Business Name | FERMAN OPTOMETRY PC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 217 N SHELDON RD
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City | PLYMOUTH
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State | MI
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Zip | 48170
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Country | US
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Telephone | 734-453-4870
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Fax | 734-453-2849
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Provider Business Mailing Address
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Address Line | 217 N SHELDON RD
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City | PLYMOUTH
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State | MI
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Zip | 48170-1524
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Country | US
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Telephone | 734-453-4870
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Fax | 734-453-2849
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Authorized Official
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Title or Position | DOCTOR OF OPTOMERTY
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Name | DR. ANDREW EALOVEGA
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Credential | OD
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Telephone | 734-453-4870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 4901003867
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License Number State | MI
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