Provider Demographics
NPI:1356488597
Name:VISION SPECIALISTS OF BIRMINGHAM, PLLC
Entity Type:Organization
Organization Name:VISION SPECIALISTS OF BIRMINGHAM, PLLC
Other - Org Name:VISION SPECIALISTS OF MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-258-9000
Mailing Address - Street 1:2550 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0950
Mailing Address - Country:US
Mailing Address - Phone:248-258-9000
Mailing Address - Fax:248-499-6372
Practice Address - Street 1:2550 S TELEGRAPH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0950
Practice Address - Country:US
Practice Address - Phone:248-258-9000
Practice Address - Fax:248-499-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900F323150OtherBLUE CROSS
MI5262650001Medicare NSC
MI900F323150OtherBLUE CROSS