Isaac, Ellery

Isaac, Ellery is an sole proprietor health care provider with primary practice located at 4114 W Maple Rd , Bloomfield Hills MI 48301. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Isaac, Ellery can be contacted via phone (248) 539-4800.

Contact Information

Primary practice address
4114 W Maple Rd Bloomfield Hills MI 48301
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901005069 Michigan

Profile Details

NPI number 1639699135
LBN Legal business name Isaac, Ellery
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2017
Last updated Jul 15th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639699135 NPPES
Michigan MEDICAID 4901005069

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