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29245 Ryan Rd, Ste. 100, Warren, MI 48092-4224 | |
(586) 558-2981 | |
(586) 558-8838 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 29245 Ryan Rd, Warren, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891989547 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | JV003935 (Michigan) | Secondary |
152W00000X | Optometrist | 4901004738 (Michigan) | Secondary |
207W00000X | Ophthalmology | PS066663 (Michigan) | Primary |
Provider Name | Piero A Simone |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1497769624 PECOS PAC ID: 3971536079 Enrollment ID: I20050917000394 |
Provider Name | Jeffrey Richard Varanelli |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1396792016 PECOS PAC ID: 7719983683 Enrollment ID: I20061017000247 |
Provider Name | Abby L Maus |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104109446 PECOS PAC ID: 8426221094 Enrollment ID: I20111026000353 |
Provider Name | Colleen E Downey |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1609350149 PECOS PAC ID: 3072938703 Enrollment ID: I20200729000489 |
Provider Name | Paul Anthony Zlojutro |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1255955050 PECOS PAC ID: 8022430974 Enrollment ID: I20241028001420 |
Mailing Address | Practice Location Address |
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29245 Ryan Rd, Ste. 100, Warren, MI 48092-4224 Ph: (586) 558-2981 | 29245 Ryan Rd, Ste. 100, Warren, MI 48092-4224 Ph: (586) 558-2981 |