MEDICARE: FREDERICK W. SCARPACE O.D. P.C.

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1326181926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICK W. SCARPACE O.D. P.C.

Provider Business Mailing Address
First Line	:	25350 W WARREN ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2102
Country	:	US
Telephone Number	:	313-563-2020
Fax Number	:	313-274-1605

Provider Business Practice Location Address
First Line	:	25350 W WARREN ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2102
Country	:	US
Telephone Number	:	313-563-2020
Fax Number	:	313-274-1605

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FREDERICK W SCARPACE
Credential	:	O.D.
Telephone Number	:	313-563-2020

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	04/15/2008

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