MEDICARE: DR. ERWIN ADELMAN 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
1	152W00000X	Optometrist	4901002169	MI

General Provider Information

NPI Number	:	1699816694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERWIN ADELMAN OD

Provider Business Mailing Address
First Line	:	6476 ORCHARD LAKE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-2337
Country	:	US
Telephone Number	:	313-565-6565
Fax Number	:	313-565-0579

Provider Business Practice Location Address
First Line	:	6476 ORCHARD LAKE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-2337
Country	:	US
Telephone Number	:	248-851-6300
Fax Number	:	248-538-1460

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

Provider Enumeration Date	:	02/11/2007
Last Update Date	:	10/30/2008

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