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Individual

DR. MARIA SHAJIDA ESPAT REICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
55 E STEWART AVE STE B, MEDFORD, OR 97501-7944
(541) 779-9851
(541) 779-9853
Mailing address
55 E STEWART AVE, STE B, MEDFORD, OR 97501-7944
(541) 779-9851
(541) 779-9853

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2640AT
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111673
PROVIDENCE PREFERRED
01
150518
OMAP PROVIDER ID#
05
150518
OR
01
205038
COLE MANAGED VISION
01
410048870
RR MEDICARE
Enumeration date
08/24/2005
Last updated
06/16/2020
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