Organization
SOUTH BALTIMORE EYE ASSOCITATE INC.
Active
Other names
Federal Hill Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALVERT ROSS BREGEL JR. O.D. (OWNER)
(410) 752-8208
Entity
Organization
Contact information
Practice address
1029 LIGHT ST, BALTIMORE, MD 21230-4017
(410) 752-8208
(410) 752-7144
Mailing address
1029 LIGHT ST, BALTIMORE, MD 21230-4017
(410) 752-8208
(410) 752-7144
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA0876
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07883
SPECTERA
MD
01
—
1084940001
MEDICARE DME
MD
01
—
210070
NVA
MD
01
—
331
BALTIMORE CITY VISION
MD
01
—
50349
DAVIS
MD
01
—
50383
MAMSI OPT CHOICE
MD
01
—
52142903
BLUE CROSS
MD
01
—
90492
BLOCK
MD
01
—
AS12101560001
CIGNA
MD
Enumeration date
12/14/2006
Last updated
05/17/2011
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