Provider Demographics
NPI:1073409090
Name:MAX H ENGELMAN
Entity type:Organization
Organization Name:MAX H ENGELMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:H
Authorized Official - Last Name:ENGELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-330-1333
Mailing Address - Street 1:15666 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WOLVERINE
Mailing Address - State:MI
Mailing Address - Zip Code:49799-9710
Mailing Address - Country:US
Mailing Address - Phone:231-330-1333
Mailing Address - Fax:
Practice Address - Street 1:225 STATE ST
Practice Address - Street 2:
Practice Address - City:BOYNE CITY
Practice Address - State:MI
Practice Address - Zip Code:49712-1202
Practice Address - Country:US
Practice Address - Phone:231-330-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty