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NPI Code Detail

MEDICARE: REGIONAL EYE ASSOCIATES,INC.

MEDICARE: REGIONAL EYE ASSOCIATES,INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255501862
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGIONAL EYE ASSOCIATES,INC.
Provider Business Mailing Address
First Line : 1255 PINEVIEW DRIVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-2713
Country : US
Telephone Number : 304-598-3301
Fax Number : 304-599-7346
Provider Business Practice Location Address
First Line : 888 MEMORIAL DR
Second Line : SUITE 201
City : OAKLAND
State : MD
Zip : 21550-5112
Country : US
Telephone Number : 301-334-1146
Fax Number : 304-599-7346
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEPHEN R POWELL
Credential : M.D.
Telephone Number : 304-598-3301
Provider Enumeration Date : 03/11/2008
Last Update Date : 03/11/2008

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Directions to “REGIONAL EYE ASSOCIATES,INC. ” Practice Location

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