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Organization

AZAR/FILIPOV MD PA

Active
Parent organization
AZAR/FILIPOV MD PA
Other names
The Optical Shop @ Azar Eye
Organization subpart
Yes

Provider details

NPI number
Legal business name
AZAR/FILIPOV MD PA
Authorized official
SUSAN DONOWAY RN (CREDENTIALING COORDINATOR)
(410) 546-2500
Entity
Organization

Contact information

Practice address
11031 NICHOLAS LN STE 2, BERLIN, MD 21811-3296
(410) 546-2500
Mailing address
11031 NICHOLAS LN STE 2, BERLIN, MD 21811-3296
(410) 546-2500

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
156FX1800X
Optician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
063341100
MD
Enumeration date
08/05/2020
Last updated
09/24/2021
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