Provider Demographics
NPI:1104188515
Name:COMPREHENSIVE VISION CENTER P.C.
Entity Type:Organization
Organization Name:COMPREHENSIVE VISION CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-826-4929
Mailing Address - Street 1:PO BOX 3820
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-3820
Mailing Address - Country:US
Mailing Address - Phone:248-826-4929
Mailing Address - Fax:248-278-6096
Practice Address - Street 1:321 PETTIBONE ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-6000
Practice Address - Country:US
Practice Address - Phone:248-782-8120
Practice Address - Fax:248-278-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080629207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1669493342Medicaid
MIN14190006Medicare PIN
MI1669493342Medicaid