MEDICARE: SEEMA MOHANAN 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	0618001591	VA

General Provider Information

NPI Number	:	1124129705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEEMA MOHANAN OD

Provider Business Mailing Address
First Line	:	1950 OLD GALLOWS RD
Second Line	:	STE 520
City	:	VIENNA
State	:	VA
Zip	:	22182-3990
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:	703-847-5177

Provider Business Practice Location Address
First Line	:	4555 DUKE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-2503
Country	:	US
Telephone Number	:	703-370-7111
Fax Number	:	703-751-4501

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/01/2009

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Directions to “ SEEMA MOHANAN OD” Practice Location

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