Healthcare Provider Details

I. General information

NPI: 1871484436
Provider Name (Legal Business Name): HANAN M. MDEWAY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7347 BELL CREEK RD STE 200
MECHANICSVILLE VA
23111-3504
US

IV. Provider business mailing address

PO BOX 45923
BALTIMORE MD
21297-5923
US

V. Phone/Fax

Practice location:
  • Phone: 804-746-5245
  • Fax: 804-249-4984
Mailing address:
  • Phone: 877-969-0392
  • Fax: 804-658-0582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618003554
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: