Provider Demographics
NPI:1437242922
Name:UNGER, LYNNE (OD)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:UNGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 VERNON
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441
Mailing Address - Country:US
Mailing Address - Phone:231-739-7124
Mailing Address - Fax:231-739-7536
Practice Address - Street 1:3445 HENRY ST STE 100
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4261
Practice Address - Country:US
Practice Address - Phone:231-220-0223
Practice Address - Fax:231-220-0224
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1437242922152W00000X
MI4901003283152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU16519Medicare UPIN