=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689904682
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANNE M. PFEFFER O.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2010
-----------------------------------------------------
Last Update Date | 03/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 343 S. UNION ST
-----------------------------------------------------
City | SPARTA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49345-1531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-887-2020
-----------------------------------------------------
Fax | 616-887-3777
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 343 S. UNION ST
-----------------------------------------------------
City | SPARTA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49345-1531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-887-2020
-----------------------------------------------------
Fax | 616-887-3777
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR/OWNER
-----------------------------------------------------
Name | DR. ANNE MICHELLE EINIG
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 616-887-2020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 4901004322
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------