Healthcare Provider Details

I. General information

NPI: 1518232412
Provider Name (Legal Business Name): MEDICAL EYE ASSOCIATES OF ROCKVILLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 KING FARM BLVD SUITE 135
ROCKVILLE MD
20850-5979
US

IV. Provider business mailing address

7840 MONTGOMERY RD
CINCINNATI OH
45236-4301
US

V. Phone/Fax

Practice location:
  • Phone: 301-926-2374
  • Fax: 301-869-3172
Mailing address:
  • Phone: 513-354-5808
  • Fax: 513-354-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0064992
License Number StateMD

VIII. Authorized Official

Name: DR. MICHAEL SUMMERFIELD
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 410-961-4283