Provider Demographics
NPI:1790812964
Name:FITE EYE CENTER, PLLC
Entity Type:Organization
Organization Name:FITE EYE CENTER, PLLC
Other - Org Name:STEVEN W. FITE, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:FITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-226-2020
Mailing Address - Street 1:PO BOX 380803
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-0071
Mailing Address - Country:US
Mailing Address - Phone:586-226-2020
Mailing Address - Fax:586-286-0407
Practice Address - Street 1:16530 19 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1106
Practice Address - Country:US
Practice Address - Phone:586-226-2020
Practice Address - Fax:586-286-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISF062293207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1805007491OtherBLUE CROSS BLUE SHIELD
MIG55235OtherHAP
MI0N31190Medicare PIN
MIG55235OtherHAP