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General NPI Number Information
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NPI Number | 1245479336
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Entity Type | Organization
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Legal Business Name | DR. ALEXANDER C NNABUE AND ASSOCIATES PA
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 8931 WOODYARD RD
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City | CLINTON
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State | MD
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Zip | 20735-4203
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Country | US
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Telephone | 301-877-1770
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Fax | 301-877-3207
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Provider Business Mailing Address
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Address Line | 10240 LAKE ARBOR WAY
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City | MITCHELLVILLE
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State | MD
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Zip | 20721-3113
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Country | US
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Telephone | 301-324-9500
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Fax | 301-324-9502
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | DR. PATRICIA PARKS
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Credential |
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Telephone | 517-231-4086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TA1277
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License Number State | MD
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