MEDICARE: STERLING OPTICAL

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

General Provider Information

NPI Number	:	1760696751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STERLING OPTICAL

Provider Business Mailing Address
First Line	:	3423 FORT MEADE RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724
Country	:	US
Telephone Number	:	301-776-2565
Fax Number	:

Provider Business Practice Location Address
First Line	:	3423 FORT MEADE RD STERLING OPTICAL
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724
Country	:	US
Telephone Number	:	301-776-2565
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ONIMITZ LEE LEE
Credential	:
Telephone Number	:	301-490-7772

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	06/18/2008

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Directions to “STERLING OPTICAL ” Practice Location

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