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General NPI Number Information
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NPI Number | 1780766154
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Entity Type | Individual
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Provider Name | DEANNA J SCHEERENS O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 580 SOUTH NICOLET STREET MACKINAW CITY
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City | MACKINAW CITY
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State | MI
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Zip | 49701
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Country | US
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Telephone | 231-436-2020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 427 MACKINAW CITY
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City | MACKINAW CITY
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State | MI
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Zip | 49701-0427
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Country | US
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Telephone | 231-436-2020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901003647
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License Number State | MI
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