Provider Demographics
NPI:1619270972
Name:ST CLAIR EYE PLLC
Entity Type:Organization
Organization Name:ST CLAIR EYE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MURRAY
Authorized Official - Last Name:CAISTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:586-727-8000
Mailing Address - Street 1:3443 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:CASCO
Mailing Address - State:MI
Mailing Address - Zip Code:48064-1000
Mailing Address - Country:US
Mailing Address - Phone:586-727-8000
Mailing Address - Fax:586-727-8000
Practice Address - Street 1:3443 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:CASCO
Practice Address - State:MI
Practice Address - Zip Code:48064-1000
Practice Address - Country:US
Practice Address - Phone:586-727-8000
Practice Address - Fax:586-727-8000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003304152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOG40116OtherBLUE CROSS
MIU21468Medicare UPIN
MIDR4779Medicare PIN
MIOG40116OtherBLUE CROSS