Provider Demographics
NPI:1942408448
Name:DINARDO, AMY ELAINE (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELAINE
Last Name:DINARDO
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 1:813 MARION AVE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-1017
Mailing Address - Country:US
Mailing Address - Phone:231-580-9069
Mailing Address - Fax:
Practice Address - Street 1:1310 CRAMER CIR
Practice Address - Street 2:PEN 506
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2736
Practice Address - Country:US
Practice Address - Phone:231-591-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004435152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist