Theodoroff, Christopher David
Theodoroff, Christopher David is an sole proprietor health care provider with primary practice located at 28825 Ryan Rd , Warren MI 48092-4128. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Theodoroff, Christopher David can be contacted via phone (586) 573-0470.Contact Information
Primary practice address
28825 Ryan Rd
Warren MI 48092-4128
Phone: (586) 573-0470
Fax: (586) 573-0648
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901003333 | Michigan |
Profile Details
| NPI number | 1982611745 |
|---|---|
| LBN Legal business name | Theodoroff, Christopher David |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Jul 10th, 2008 - about 16 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 | 1982611745 | NPPES |
| Michigan | MEDICAID | 2674552 | |
| Michigan | MEDICAID | 5189678 | |
| Michigan | Other | 1314720001 | |
| Michigan | Other | 900E066750 | |
| Michigan | MEDICAID | 5189669 |
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