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General NPI Number Information
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NPI Number | 1942440789
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Entity Type | Organization
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Legal Business Name | IVAN H GARCIA MD PC
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 2925 LORD BALTIMORE DR SUITE 300
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City | BALTIMORE
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State | MD
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Zip | 21244-2634
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Country | US
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Telephone | 410-277-3937
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Fax | 410-281-9388
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Provider Business Mailing Address
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Address Line | 2925 LORD BALTIMORE DR SUITE 300
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City | BALTIMORE
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State | MD
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Zip | 21244-2634
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Country | US
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Telephone | 410-277-3937
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Fax | 410-281-9388
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Authorized Official
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Title or Position | FOUNDING MEMBER
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Name | MR. EDWARD JOHN WASLOSKI
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Credential | O.D.
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Telephone | 410-277-3937
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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 |
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License Number State |
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