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General NPI Number Information
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NPI Number | 1467694323
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Entity Type | Organization
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Legal Business Name | EYE M EID INC
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 4895 WINDWARD PKWY SUITE 202
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City | ALPHARETTA
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State | GA
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Zip | 30004-3850
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Country | US
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Telephone | 678-240-0031
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Fax | 678-240-0455
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Provider Business Mailing Address
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Address Line | 4895 WINDWARD PKWY SUITE 202
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City | ALPHARETTA
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State | GA
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Zip | 30004-3850
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Country | US
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Telephone | 678-240-0031
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Fax | 678-240-0455
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAMED EID
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Credential | OD
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Telephone | 678-240-0031
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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 | OPT002360
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License Number State | GA
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