Individual provider Active NPI

David M Eulau, O.D.

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1609858398
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1060 Issued in SC
Practice address
1113 Market Center Blvd
Suite H
Mount Pleasant, SC 29464-7468
Phone
(843) 849-0863
Fax
(843) 849-1748
NPI assigned
Nov 17, 2005
Last updated
Jun 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1060 SC Primary

Addresses

Primary practice location

1113 Market Center Blvd
Suite H
Mount Pleasant, SC 29464-7468

Mailing address

1113 Market Center Blvd
Suite H
Mount Pleasant, SC 29464-7468
Phone (843) 849-0863

Other identifiers 1

IdentifierTypeStateIssuer
D10600MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071025000230 SC Practitioner - Optometry 5698862571 Practice locations: Mt Pleasant, SC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: davideulau@direct.revolutionehr.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1609858398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 MARKET CENTER BLVD",
            "address_2": "SUITE H",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294647468",
            "telephone_number": "843-849-0863",
            "fax_number": "843-849-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 MARKET CENTER BLVD",
            "address_2": "SUITE H",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294647468",
            "telephone_number": "843-849-0863",
            "fax_number": "843-849-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EULAU",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10600",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.