Provider Demographics
NPI:1134376163
Name:OESCH, ANNIE MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:MARIE
Last Name:OESCH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:MARIE
Other - Last Name:ZALOKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 28TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49512-2049
Mailing Address - Country:US
Mailing Address - Phone:616-233-4403
Mailing Address - Fax:616-233-4429
Practice Address - Street 1:5100 28TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-2049
Practice Address - Country:US
Practice Address - Phone:616-233-4403
Practice Address - Fax:616-233-4429
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004484152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist