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General NPI Number Information
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NPI Number | 1740483429
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Entity Type | Organization
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Legal Business Name | PENNYE DOUD & ASSOCIATES, PC
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 130 HOLIDAY CT STE 109
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7003
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Country | US
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Telephone | 410-266-0099
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Fax | 410-266-8629
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Provider Business Mailing Address
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Address Line | 130 HOLIDAY CT STE 109
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7003
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Country | US
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Telephone | 410-266-0099
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Fax | 410-266-8629
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Authorized Official
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Title or Position | MANAGER
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Name | CHRISTINE D BROWN
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Credential |
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Telephone | 410-266-0099
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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 | TA1038
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License Number State | MD
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