Provider Demographics
NPI:1447557764
Name:CHESTERFIELD EYE CARE P.C.
Entity Type:Organization
Organization Name:CHESTERFIELD EYE CARE P.C.
Other - Org Name:EXPERTEYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:WEISGERBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:586-598-3937
Mailing Address - Street 1:8703 26 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-2967
Mailing Address - Country:US
Mailing Address - Phone:586-992-3700
Mailing Address - Fax:586-992-3706
Practice Address - Street 1:27903 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2328
Practice Address - Country:US
Practice Address - Phone:586-598-3937
Practice Address - Fax:586-598-3941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI152W00000X, 152WC0802X, 152WP0200X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP30340002Medicare PIN