Provider Demographics
NPI:1053302851
Name:MINDLIN, ALAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:MINDLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1750 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0179
Mailing Address - Country:US
Mailing Address - Phone:248-334-4906
Mailing Address - Fax:248-334-2710
Practice Address - Street 1:1750 S TELEGRAPH RD
Practice Address - Street 2:SUITE 303
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0179
Practice Address - Country:US
Practice Address - Phone:248-334-4906
Practice Address - Fax:248-334-2710
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-11-28
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Provider Licenses
StateLicense IDTaxonomies
MI4901030751207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1081667Medicaid
MI1081667Medicaid