Healthcare Provider Details

I. General information

NPI: 1275730491
Provider Name (Legal Business Name): EYE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 GREENBELT RD
BERWYN HEIGHTS MD
20740-2257
US

IV. Provider business mailing address

5701 GREENBELT RD
BERWYN HEIGHTS MD
20740-2257
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-1800
  • Fax: 301-596-5070
Mailing address:
  • Phone: 301-345-2053
  • Fax: 301-592-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES R MUND
Title or Position: MANAGING PARTNER
Credential: OD
Phone: 301-345-2053