Provider Demographics
NPI:1508830662
Name:POSAR POPPER, LORI ROBIN (OD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ROBIN
Last Name:POSAR POPPER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:ROBIN
Other - Last Name:POSAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:29325 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-553-8270
Mailing Address - Fax:248-553-8185
Practice Address - Street 1:29325 ORCHARD LAKE ROAD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-553-8270
Practice Address - Fax:248-553-8185
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4901003027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7856OtherEYE MED/COLE
IL7856OtherEYE MED/COLE
N47800002Medicare ID - Type Unspecified