Provider Demographics
NPI:1538852751
Name:FRITZ, MIKAYLA G I
Entity type:Individual
Prefix:MS
First Name:MIKAYLA
Middle Name:G
Last Name:FRITZ
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32100 TELEGRAPH RD STE 185
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2453
Mailing Address - Country:US
Mailing Address - Phone:248-712-4266
Mailing Address - Fax:248-712-4381
Practice Address - Street 1:32100 TELEGRAPH RD STE 185
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-2453
Practice Address - Country:US
Practice Address - Phone:248-712-4266
Practice Address - Fax:248-712-4381
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist