Herbert Michael Archey, O.D.
Individual provider Active NPI Optometrist · Waldorf, MD
NPI 1114085099 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114085099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- DA1362 (MD)
- Practice address
- 3134 Crain Hwy
Waldorf, MD 20603-4846 - Phone
- (301) 374-9615
- Fax
- (301) 374-9616
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA1362 | MD | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | DA1362 | MD | Yes |
Addresses
Primary practice location
3134 Crain Hwy
Waldorf, MD 20603-4846
Mailing address
4109 Westman CT
Alexandria, VA 22306-1259
Phone (703) 765-2607
Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.