MEDICARE: MARY WASHINGTON EYE CARE CENTER, LLC

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
2	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1720301625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY WASHINGTON EYE CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	2300 FALL HILL AVE
Second Line	:	SUITE 509
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-3342
Country	:	US
Telephone Number	:	540-741-1821
Fax Number	:	540-741-1097

Provider Business Practice Location Address
First Line	:	4710 SPOTSYLVANIA PKWY
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9433
Country	:	US
Telephone Number	:	540-741-2733
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. CHRISTOPHER D NEWMAN
Credential	:
Telephone Number	:	540-741-3248

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	04/22/2025

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