MEDICARE: DR. PAUL KENT VOREIS O.D.

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
1	152WP0200X	Pediatric Optometrist	4901002567	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205827383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL KENT VOREIS O.D.

Provider Business Mailing Address
First Line	:	21947 CANTERBURY AVE
Second Line	:
City	:	GROSSE ILE
State	:	MI
Zip	:	48138-1308
Country	:	US
Telephone Number	:	734-676-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	17901 HURON RIVER DR
Second Line	:	SUITE 101
City	:	NEW BOSTON
State	:	MI
Zip	:	48164-3200
Country	:	US
Telephone Number	:	734-753-9360
Fax Number	:	734-753-9311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2005
Last Update Date	:	03/12/2009

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