MEDICARE: DR. MARIE ELIZABETH HUEGEL OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2662	NC
2	152W00000X	Optometrist	3732	MN

General Provider Information

NPI Number	:	1114596723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE ELIZABETH HUEGEL OD

Provider Business Mailing Address
First Line	:	14032 WOODY POINT RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-6923
Country	:	US
Telephone Number	:	412-715-9351
Fax Number	:

Provider Business Practice Location Address
First Line	:	9651 BROOKDALE DR STE 800
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-8105
Country	:	US
Telephone Number	:	704-536-6042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2021
Last Update Date	:	07/29/2022

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