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NPI Code Detail

MEDICARE: EYE ONE SURGICAL ASSOC

MEDICARE: EYE ONE SURGICAL ASSOC
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 Physician20210DC

General Provider Information

NPI Number : 1720180276
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE ONE SURGICAL ASSOC
Provider Business Mailing Address
First Line : 560 N ST SW
Second Line : SUITE N616
City : WASHINGTON
State : DC
Zip : 20024-4605
Country : US
Telephone Number : 202-339-0001
Fax Number :
Provider Business Practice Location Address
First Line : 3800 RESERVOIR RD NW
Second Line : PHC BLDG #GL017
City : WASHINGTON
State : DC
Zip : 20007-2113
Country : US
Telephone Number : 202-339-0001
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. DEBORAH YVONNE WILSON-UMANZOR
Credential : M.D.
Telephone Number : 202-339-0001
Provider Enumeration Date : 09/04/2006
Last Update Date : 08/22/2020

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Directions to “EYE ONE SURGICAL ASSOC ” Practice Location

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