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Anthony James Paveglio

Optometrist

Eye and Vision Services Providers

52799 Hays Rd, Shelby Township, MI 48315

PECOS Enrollment

Based on the most recent information from CMS, provider Anthony James Paveglio does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1093861171
Provider Type
Individual
Full Name
Paveglio, Anthony James
Credential
OD

Gender
Male
Sole Proprietor
No
Enumeration Date
1/25/2007
Last Updated
7/17/2009

Contact Information

Practice Location

52799 Hays Rd, Shelby Township, MI 48315

(586) 247-2652

Unlisted Fax

Mailing Location

140 Macomb, Mt Clemens, MI 48043

(586) 468-7370

(586) 464-1472

Provider Taxonomies

Code	Description	License
Code 152W00000X Primary	Description Optometrist Eye and Vision Services Providers	License 4901003257 Michigan

Provider Identifiers

ID	Description	Issuer
ID 944500196	Description Medicaid	Issuer Unlisted Michigan

Anthony James Paveglio

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Myeyedr Optometry Of Michigan, Llc

Chrustowski, John David

Charbeneau, David Patrick

Leppek, Adrianna L.

Optical Management Services, Llc