Provider Demographics
NPI:1326128810
Name:EINIG, ANNE MICHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MICHELLE
Last Name:EINIG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:MICHELLE
Other - Last Name:PFEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:343 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:MI
Mailing Address - Zip Code:49345-1531
Mailing Address - Country:US
Mailing Address - Phone:616-887-2020
Mailing Address - Fax:616-887-3777
Practice Address - Street 1:343 S UNION ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:MI
Practice Address - Zip Code:49345-1531
Practice Address - Country:US
Practice Address - Phone:616-887-2020
Practice Address - Fax:616-887-3777
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004322152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900A111110OtherBCBS
MI900068662OtherPRIORITY HEALTH
MIMI2789001Medicare PIN
MI900068662OtherPRIORITY HEALTH
MI900068662OtherPRIORITY HEALTH