Michele Andrews, OD
Individual provider Active NPI Optometrist · Mason, OH
NPI 1063644201 · NPPES record last updated Aug 21, 2009
Key facts
- NPI
- 1063644201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046008603 (IL)
- Practice address
- 3781 Blossom CT
Mason, OH 45040-4119 - Phone
- (513) 313-9216
- Fax
- (513) 492-6772
- NPI assigned
- Aug 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046008603 | IL | MD | Optometrist |
| T006828-1 | NY | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046008603 | IL | Yes |
| Optometrist | 152W00000X | T006828-1 | NY |
Addresses
Primary practice location
3781 Blossom CT
Mason, OH 45040-4119
Mailing address
4000 Luxottica PL
Mason, OH 45040-8114
Phone (513) 313-9216
Other providers in Mason, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.