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General NPI Number Information
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NPI Number | 1205081841
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Entity Type | Organization
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Legal Business Name | CARNEY RETINA AND MACULA CENTER PC
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 4433 CORPORATION LN CORPORATION IV SUITE 195
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3351
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Country | US
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Telephone | 757-227-6340
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Fax | 804-754-1428
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Provider Business Mailing Address
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Address Line | PO BOX 61785 CARNEY RETINA MACULA CENTER PC
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City | VIRGINIA BEACH
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State | VA
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Zip | 23466-1785
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Country | US
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Telephone | 757-227-6340
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Fax | 804-754-1428
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARCIA D CARNEY
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Credential | MD
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Telephone | 757-227-6340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101033260
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License Number State | VA
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