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NPI Code Detail

MEDICARE: DR. RYAN CHAHINE OD

MEDICARE:  DR. RYAN  CHAHINE  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist4901005085MI

General Provider Information

NPI Number : 1013428648
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN CHAHINE OD
Provider Business Mailing Address
First Line : 106 W 12 MILE RD
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-2416
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 106 W 12 MILE RD
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-2416
Country : US
Telephone Number : 248-414-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2017
Last Update Date : 01/15/2018

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Directions to “ DR. RYAN CHAHINE OD” Practice Location

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