Provider Demographics
NPI:1760230197
Name:RAYESS, NADINE
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:RAYESS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:NADINE
Other - Middle Name:
Other - Last Name:RAYESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10791 BELLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-1097
Mailing Address - Country:US
Mailing Address - Phone:734-381-3080
Mailing Address - Fax:
Practice Address - Street 1:10791 BELLEVILLE RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48111-1097
Practice Address - Country:US
Practice Address - Phone:734-391-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005804152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist