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General NPI Number Information
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NPI Number | 1942425905
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC PHOTOGRAPHY INC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 3131 ENCLAVE CT
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City | BALTIMORE
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State | MD
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Zip | 21208-3337
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Country | US
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Telephone | 410-328-6533
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Fax | 410-328-1178
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Provider Business Mailing Address
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Address Line | 3131 ENCLAVE CT
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City | BALTIMORE
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State | MD
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Zip | 21208-3337
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Country | US
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Telephone | 410-328-6533
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Fax | 410-328-1178
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. ROBERT A LISS
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Credential | MD
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Telephone | 410-328-5934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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