Provider Demographics
NPI:1144582438
Name:VITREORETINAL SPECIALISTS PLC
Entity Type:Organization
Organization Name:VITREORETINAL SPECIALISTS PLC
Other - Org Name:RETINA ASSOCIATES OF MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NARESH
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-487-4500
Mailing Address - Street 1:8562 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8301
Mailing Address - Country:US
Mailing Address - Phone:810-487-4500
Mailing Address - Fax:810-991-8228
Practice Address - Street 1:8562 HOLLY RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8301
Practice Address - Country:US
Practice Address - Phone:810-487-4500
Practice Address - Fax:810-991-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301089275207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty