Basic Information
Provider Information
NPI: 1134358948
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHEINKER
FirstName: AARON
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13350 FORT ST
Address2:  
City: SOUTHGATE
State: MI
PostalCode: 48195
CountryCode: US
TelephoneNumber: 7342842020
FaxNumber: 7342840020
Practice Location
Address1: 10788 BELLEVILLE RD
Address2:  
City: BELLEVILLE
State: MI
PostalCode: 481111308
CountryCode: US
TelephoneNumber: 7346976671
FaxNumber: 7346979332
Other Information
ProviderEnumerationDate: 07/14/2009
LastUpdateDate: 09/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X4901004527MIY Eye and Vision Services ProvidersOptometrist 

No ID Information.


Home