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EAST DETROIT OPHTHALMOLOGY P.C.
NPI 1124181763
Specialist in Eastpointe, MI

Active since December 18, 2006
22835 KELLY RD, EASTPOINTE, MI 48021(586) 778-4400(586) 778-3642 Get Directions Write a Review

NPPES record last updated: March 1, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About East Detroit Ophthalmology P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST DETROIT OPHTHALMOLOGY P.C. (NPI 1124181763) is a healthcare organization registered as a specialist in Eastpointe, Michigan and active in the NPI registry since December 2006. The organization lists John Colombo, President, as its authorized official.

NPPES Registry Identity

NPI1124181763
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameEAST DETROIT OPHTHALMOLOGY P.C.
Location Address22835 KELLY RDEastpointe, MI 48021-2073
Mailing Address22835 Kelly RdEastpointe, MI 48021-2073 · (586) 778-4400 · Fax (586) 778-3642
Phone(586) 778-4400
Fax(586) 778-3642
Organization SubpartNo
Authorized OfficialJohn ColomboPresident · (586) 778-4400
Enumeration DateDecember 18, 2006
Last NPPES UpdateMarch 1, 2010
✔ NPI 1124181763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MI · JC026758
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
22835 KELLY RD, Eastpointe, MI 48021
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Other Identifiers 5

Medicare NSC0179220001MI
OtherOEO7713MI · Blue Cross Blue Shield
Medicaid3456128MI
Medicare UPINA75096MI
Medicare ID-Type UnspecifiedOEO7713MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Detroit Ophthalmology P.C.'s NPI number?

The NPI number for East Detroit Ophthalmology P.C. is 1124181763. It was assigned to this organization in the NPPES registry on December 18, 2006.

Where is East Detroit Ophthalmology P.C. located?

East Detroit Ophthalmology P.C. is located at 22835 Kelly Rd, Eastpointe, MI 48021. The listed phone number is (586) 778-4400.

What is East Detroit Ophthalmology P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for East Detroit Ophthalmology P.C. was last updated on March 1, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.