MEDICARE: DR. ERIC VAN METER OD

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	152W00000X	Optometrist	3795	CO

General Provider Information

NPI Number	:	1881332914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC VAN METER OD

Provider Business Mailing Address
First Line	:	15901 E BRIARWOOD CIR UNIT 100
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-1781
Country	:	US
Telephone Number	:	303-699-3107
Fax Number	:

Provider Business Practice Location Address
First Line	:	15901 E BRIARWOOD CIR UNIT 100
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-1781
Country	:	US
Telephone Number	:	303-699-3107
Fax Number	:	303-699-3170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2022
Last Update Date	:	09/14/2024

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