| Dale W Muth Od Pllc | |
|
504 W Harrie St, Newberry, MI 49868-1200 | |
| (902) 293-9276 | |
| (906) 293-9100 |
| Full Name | Dale W Muth Od Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 504 W Harrie St, Newberry, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255463162 | NPI | - | NPPES |
| 900D800030 | Other | MI | BCBS OF MICHIGAN |
| 944255821 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4901003944 (Michigan) | Primary |
| Provider Name | Dale W Muth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659380293 PECOS PAC ID: 2961444096 Enrollment ID: I20050527000639 |
| Provider Name | Jessica Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780023234 PECOS PAC ID: 6901031012 Enrollment ID: I20131026000059 |
| Provider Name | Derek James Dake |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740766716 PECOS PAC ID: 9436408556 Enrollment ID: I20180823000926 |
| Mailing Address | Practice Location Address |
|---|---|
| Dale W Muth Od Pllc 504 W Harrie St, Newberry, MI 49868-1200 Ph: (902) 293-9276 | Dale W Muth Od Pllc 504 W Harrie St, Newberry, MI 49868-1200 Ph: (902) 293-9276 |
Dr. Dale W Muth, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 504 W Harrie St, Newberry, MI 49868 Phone: 906-293-9276 Fax: 906-293-9100 | |
Dr. Derek James Dake, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 504 W Harrie St, Newberry, MI 49868 Phone: 906-291-2015 | |
Derek J Dake Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 504 W Harrie St, Newberry, MI 49868 Phone: 906-291-2015 |