Provider Demographics
NPI:1699816694
Name:ADELMAN, ERWIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:
Last Name:ADELMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6476 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2337
Mailing Address - Country:US
Mailing Address - Phone:313-565-6565
Mailing Address - Fax:313-565-0579
Practice Address - Street 1:6476 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2337
Practice Address - Country:US
Practice Address - Phone:248-851-6300
Practice Address - Fax:248-538-1460
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002169152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU32330Medicare UPIN