Healthcare Provider Details

I. General information

NPI: 1245403856
Provider Name (Legal Business Name): AZAR/FILIPOV MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31519 WINTERPLACE PKWY SUITE 1
SALISBURY MD
21804-1884
US

IV. Provider business mailing address

31519 WINTERPLACE PKWY SUITE 1
SALISBURY MD
21804-1884
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-2500
  • Fax: 410-546-5005
Mailing address:
  • Phone: 410-546-2500
  • Fax: 410-546-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEX AZAR
Title or Position: PRESIDENT
Credential: MD
Phone: 410-546-2500