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General NPI Number Information
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NPI Number | 1942598248
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Entity Type | Individual
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Provider Name | ANDREA CMEJLA O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 160 LAKEVIEW DR
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City | NOBLESVILLE
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State | IN
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Zip | 46060-1307
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Country | US
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Telephone | 317-773-4482
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Fax | 317-776-2520
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Provider Business Mailing Address
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Address Line | 15243 BEAM ST
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City | NOBLESVILLE
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State | IN
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Zip | 46060-4694
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Country | US
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Telephone | 317-908-1830
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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 | 18003678A
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License Number State | IN
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