Provider Demographics
NPI:1720020332
Name:TIJUNELIS, MARIUS A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIUS
Middle Name:A
Last Name:TIJUNELIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE CENTER FOR SIGHT
Mailing Address - Street 2:1015 LAURENCE AVENUE
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202
Mailing Address - Country:US
Mailing Address - Phone:517-787-0364
Mailing Address - Fax:
Practice Address - Street 1:THE CENTER FOR SIGHT
Practice Address - Street 2:1015 LAURENCE AVENUE
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202
Practice Address - Country:US
Practice Address - Phone:517-787-0364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81508207P00000X
MI4301096052207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A815080Medicaid
I28765Medicare UPIN