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General NPI Number Information
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NPI Number | 1467151696
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Entity Type | Organization
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Legal Business Name | COLUMBIA EYE ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 10015 OLD COLUMBIA RD STE J135
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City | COLUMBIA
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State | MD
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Zip | 21046-1741
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Country | US
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Telephone | 410-381-1688
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Fax | 410-381-3855
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Provider Business Mailing Address
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Address Line | 10015 OLD COLUMBIA RD STE J135
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City | COLUMBIA
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State | MD
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Zip | 21046-1741
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Country | US
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Telephone | 410-381-1688
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Fax | 410-381-3855
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | CHRISTOPHER A COLEMAN
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Credential | O.D.
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Telephone | 240-498-6768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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