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Organization

CAPITAL EYE PHYSICIANS & SURGEONS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. WENDY D KAUTZ CSA (ADMINISTRATOR)
(301) 809-6305
Entity
Organization

Contact information

Practice address
4000 MITCHELLVILLE RD, SUITE B-128, BOWIE, MD 20716-3104
(301) 809-6305
(301) 809-6306
Mailing address
4000 MITCHELLVILLE RD, SUITE B-128, BOWIE, MD 20716-3104
(301) 809-6305
(301) 809-6306

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
689701100
MD
05
689701103
MD
Enumeration date
03/07/2007
Last updated
10/23/2008
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