Provider Demographics
NPI:1508009432
Name:ANN ARBOR EYE CARE PLC
Entity Type:Organization
Organization Name:ANN ARBOR EYE CARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-662-2020
Mailing Address - Street 1:3200 W LIBERTY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9746
Mailing Address - Country:US
Mailing Address - Phone:734-662-2020
Mailing Address - Fax:734-662-2023
Practice Address - Street 1:3200 W LIBERTY RD
Practice Address - Street 2:SUITE D
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9746
Practice Address - Country:US
Practice Address - Phone:734-662-2020
Practice Address - Fax:734-662-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICH050306207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA76932Medicare UPIN
MI0810258Medicare PIN