Physician Compare National (NPI:1295812063)

HEALTHCARE PROVIDER: ROBERT MARK WLODEK O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1295812063
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0749242220
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090305000192
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WLODEK
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9895 S MARYLAND PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE D
	Group Practice or individual's line 2 address
City	LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	891837165
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y