Organization
MIDWAY OPTOMETRIC EYE CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL DAVID SASSER OD (OWNER)
(336) 764-2449
Entity
Organization
Contact information
Practice address
11362 OLD US HIGHWAY 52, WINSTON SALEM, NC 27107-9841
(336) 764-2449
(336) 764-4156
Mailing address
11362 OLD US HIGHWAY 52, WINSTON SALEM, NC 27107-9841
(336) 764-2449
(336) 764-4156
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1090
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0827850001
DMERC/PALMETTO
—
05
—
8909807
—
NC
Enumeration date
07/14/2010
Last updated
07/30/2010
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