Provider Demographics
NPI:1699830646
Name:PIERCE, BRIAN ERIC (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ERIC
Last Name:PIERCE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3908
Mailing Address - Country:US
Mailing Address - Phone:734-981-2700
Mailing Address - Fax:
Practice Address - Street 1:325 N LILLEY RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3908
Practice Address - Country:US
Practice Address - Phone:734-981-2700
Practice Address - Fax:734-981-0198
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003645152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU40815Medicare UPIN
MIOH26700Medicare ID - Type Unspecified