Shelby Macomb Vision Associates Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004569 Issued in MI

Legal business name

SHELBY MACOMB VISION ASSOCIATES INC

Practice address

50505 Schoenherr Rd
Ste 110
Shelby Township, MI 48315-3140

Phone

(586) 806-9333

NPI assigned

Jul 20, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Baseem Wahab, O.D.

Title

Managing Optometrist

Phone

(586) 806-9333

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1104171602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "STE 110",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-806-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "STE 110",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-806-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY MACOMB VISION ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "WAHAB",
        "authorized_official_first_name": "BASEEM",
        "authorized_official_title_or_position": "MANAGING OPTOMETRIST",
        "authorized_official_telephone_number": "586-806-9333",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.