MEDICARE: DR. CARL MASCHAUER O.D.

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	52	VI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0075199000	OTHER	DE	AMERIHEALTH

General Provider Information

NPI Number	:	1831194927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL MASCHAUER O.D.

Provider Business Mailing Address
First Line	:	PO BOX 5991
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00823-5991
Country	:	US
Telephone Number	:	340-773-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 SUNNY ISLE
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4493
Country	:	US
Telephone Number	:	302-381-2696
Fax Number	:	340-778-0977

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	06/13/2018

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