# RETINA CENTER OF WESTERN MARYLAND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043297385
- **Authorized official:** DARA TASH MD (CEO)
- **Authorized official phone:** (301) 416-8600

## Contact information

- **Practice address:** 251 E BALTIMORE ST, LOWER LEVEL, HAGERSTOWN, MD 21740-6144
- **Practice address phone:** (301) 416-8600
- **Practice address fax:** (301) 416-8602
- **Mailing address:** 251 E BALTIMORE ST, LOWER LEVEL, HAGERSTOWN, MD 21740-6144
- **Mailing address phone:** (301) 416-8600
- **Mailing address fax:** (301) 416-8602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | D0052418 | MD | Yes |

## Other

- **Enumeration date:** 12/28/2005
- **Last updated:** 02/19/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 170200900 | — | MD |