Organization
RETINA & VITREOUS CONSULTANTS OF VIRGINIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAQAS ILYAS M.D. (OWNER)
(804) 380-4525
Entity
Organization
Contact information
Practice address
905 CEDAR CREEK GRADE, SUITE 105, WINCHESTER, VA 22601-2705
(540) 662-1810
(540) 662-1812
Mailing address
905 CEDAR CREEK GRADE, SUITE 105, WINCHESTER, VA 22601-2705
(540) 662-1810
(540) 662-1812
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114172319
—
VA
05
—
3810014177
—
WV
01
—
614091000
DOL
VA
01
—
DO9443
MEDICARE RR
VA
Enumeration date
12/02/2008
Last updated
07/22/2009
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