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General NPI Number Information
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NPI Number | 1023946969
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Entity Type | Individual
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Provider Name | SPOGMAI KHAN OD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 241 CORPORATE BLVD
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City | NORFOLK
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State | VA
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Zip | 23502-4975
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Country | US
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Telephone | 757-622-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 26074 HUNTWICK GLEN SQ
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City | ALDIE
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State | VA
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Zip | 20105-5715
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Country | US
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Telephone | 703-945-2450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | NA
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License Number State | VA
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