Provider Demographics
NPI:1083172266
Name:RETINA INSTITUTE OF MICHIGAN PLLC
Entity Type:Organization
Organization Name:RETINA INSTITUTE OF MICHIGAN PLLC
Other - Org Name:RETINA INSTITUTE OF MICHIGAN PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANU
Authorized Official - Middle Name:SINGLA
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-621-0200
Mailing Address - Street 1:31500 TELEGRAPH RD STE 5
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4329
Mailing Address - Country:US
Mailing Address - Phone:248-621-0200
Mailing Address - Fax:
Practice Address - Street 1:31500 TELEGRAPH RD STE 5
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4329
Practice Address - Country:US
Practice Address - Phone:248-621-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty