Individual
GARY BAZIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1209 YORK RD, SUITE 200, LUTHERVILLE, MD 21093-6207
(410) 821-9490
(410) 821-9495
Mailing address
1209 YORK RD, SUITE 200, LUTHERVILLE, MD 21093-6207
(410) 821-9490
(410) 821-9495
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1113
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159438900
—
MD
Enumeration date
07/01/2005
Last updated
04/11/2012
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