Provider Demographics
NPI:1265455208
Name:EFTHEMIOS RAPHTIS MD PC
Entity Type:Organization
Organization Name:EFTHEMIOS RAPHTIS MD PC
Other - Org Name:BALIAN EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARETAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-651-6122
Mailing Address - Street 1:432 W. UNIVERSITY DR.
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-651-6122
Mailing Address - Fax:248-651-4825
Practice Address - Street 1:432 W. UNIVERSITY DR.
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-651-6122
Practice Address - Fax:248-651-4825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI180020279OtherMEDICARE RAILROAD
MI0F36287OtherBCBS EYE CENTER
0F36287Medicare ID - Type UnspecifiedEYE CENTER