Devries, Fredric Carl
Devries, Fredric Carl is an sole proprietor health care provider with primary practice located at 3050 Ivanrest Ave Sw , Grandville MI 49418-1400. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Devries, Fredric Carl can be contacted via phone (616) 538-0150.Contact Information
Primary practice address
3050 Ivanrest Ave Sw
Grandville MI 49418-1400
Phone: (616) 538-0150
Fax: (616) 538-3954
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901002219 | Michigan |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 4901002219 | Michigan |
Profile Details
| NPI number | 1407883416 |
|---|---|
| LBN Legal business name | Devries, Fredric Carl |
| Credentials | O.D., F.A.A.O |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Nov 20th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407883416 | NPPES |
| Michigan | MEDICAID | 0D16540 | |
| Michigan | Other | 0D16540 |
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