Individual
DR. DONNA R WIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1729 DAVIE AVE, STATESVILLE, NC 28677-3521
(704) 873-0524
(704) 873-0549
Mailing address
1950 OLD GALLOWS RD, SUITE 520, VIENNA, VA 22182-3990
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0929
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09978
BCBS
NC
05
—
8909978
—
NC
Enumeration date
08/02/2005
Last updated
09/25/2014
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