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General NPI Number Information
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NPI Number | 1538151907
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Entity Type | Individual
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Provider Name | CAROLINE HART O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 8875 A CENTRE PARK DR CENTREPARK EYECARE
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City | COLUMBIA
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State | MD
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Zip | 21045-2382
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Country | US
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Telephone | 410-884-5508
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Fax |
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Provider Business Mailing Address
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Address Line | 14742 GROBIE POND LN
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City | CENTREVILLE
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State | VA
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Zip | 20120-2989
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Country | US
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Telephone |
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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 | TA1940
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License Number State | MD
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