Advanced Family Vision Care, LLC

Organization Active NPI Optometrist · Gambrills, MD

NPI 1194139972 · NPPES record last updated Jun 19, 2014

Key facts

NPI
1194139972
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
TA2234 (MD)
Legal business name
ADVANCED FAMILY VISION CARE, LLC
Practice address
331 Gambrills Rd
Suite 3
Gambrills, MD 21054-1141
Phone
(443) 351-8079
NPI assigned
Jun 19, 2014
Organization subpart
No

Authorized official

Name
Dr. Michelle May, O.D.
Title
Doctor
Phone
(443) 351-8079

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20141112001655 MD Part B Supplier - Clinic/Group Practice 9436371184 Receives reassigned benefits from 1 practitioner
Practice locations: Gambrills, MD

National Provider Directory

Locations

331 Gambrills Rd
Ste 3
Gambrills, MD 21054
Phone (410) 923-3672

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X TA2234 MD Yes

Addresses

Primary practice location

331 Gambrills Rd
Suite 3
Gambrills, MD 21054-1141

Mailing address

331 Gambrills Rd
Suite 3
Gambrills, MD 21054-1141
Phone (443) 351-8079

Other providers in Gambrills, MD

All providers in Gambrills, MD · Optometrist in Maryland

Sources for this page

Verify at the official NPI Registry.