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General NPI Number Information
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NPI Number | 1649342205
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Entity Type | Organization
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Legal Business Name | DUBIN OPTOMETRIC ASSOCIATES, P.C.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 201 EDDIE CHASTEEN DR
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City | WALTERBORO
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State | SC
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Zip | 29488-5728
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Country | US
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Telephone | 843-549-2015
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Fax | 843-549-0104
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Provider Business Mailing Address
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Address Line | 201 EDDIE CHASTEEN DR
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City | WALTERBORO
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State | SC
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Zip | 29488-5728
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Country | US
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Telephone | 843-549-2015
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Fax | 843-549-0104
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER CHARLES DUBIN
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Credential | O.D.
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Telephone | 843-549-2015
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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 | SC925
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License Number State | SC
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