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General NPI Number Information
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NPI Number | 1740241124
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Entity Type | Organization
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Legal Business Name | RETINA CONSULTANTS, P.C.
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3289 WOODBURN RD SUITE 270
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-849-8601
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Fax |
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Provider Business Mailing Address
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Address Line | 6410 ROCKLEDGE DR SUITE 400
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City | BETHESDA
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State | MD
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Zip | 20817-1842
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Country | US
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Telephone | 301-530-5200
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Fax |
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | LORRAINE BISHOP WHITE
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Credential |
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Telephone | 301-530-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101231256
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License Number State | VA
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