| |
8625 Sudley Rd, Manassas, VA 20110-4515 | |
(703) 361-3434 | |
(703) 361-6252 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 8625 Sudley Rd, Manassas, Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720160823 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 0601002358 (Virginia) | Primary |
207W00000X | Ophthalmology | 0101033118 (Virginia) | Primary |
207W00000X | Ophthalmology | 0101046481 (Virginia) | Primary |
Provider Name | David Harvan |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1336165018 PECOS PAC ID: 0648376459 Enrollment ID: I20070510000309 |
Provider Name | Patricia D Smith |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1164446563 PECOS PAC ID: 1456457274 Enrollment ID: I20070510000326 |
Mailing Address | Practice Location Address |
---|---|
8625 Sudley Rd, Manassas, VA 20110-4515 Ph: (703) 361-3434 | 8625 Sudley Rd, Manassas, VA 20110-4515 Ph: (703) 361-3434 |