Provider Demographics
NPI:1053101824
Name:STYMA, TANIA (OD)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:STYMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:POSEN
Mailing Address - State:MI
Mailing Address - Zip Code:49776-0063
Mailing Address - Country:US
Mailing Address - Phone:989-464-4169
Mailing Address - Fax:
Practice Address - Street 1:174 N RIPLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-3402
Practice Address - Country:US
Practice Address - Phone:989-356-9096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist