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General NPI Number Information
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NPI Number | 1831194927
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Entity Type | Individual
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Provider Name | CARL MASCHAUER O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 4500 SUNNY ISLE
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-4493
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Country | US
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Telephone | 302-381-2696
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Fax | 340-778-0977
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Provider Business Mailing Address
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Address Line | PO BOX 5991
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City | CHRISTIANSTED
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State | VI
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Zip | 00823-5991
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Country | US
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Telephone | 340-773-2020
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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 | 52
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License Number State | VI
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