Provider Demographics
NPI:1508215302
Name:HEINS, EMILY ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ANN
Last Name:HEINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2245 KENAN DR
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-1315
Mailing Address - Country:US
Mailing Address - Phone:231-598-0247
Mailing Address - Fax:
Practice Address - Street 1:7230 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3603
Practice Address - Country:US
Practice Address - Phone:248-661-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004968152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist