Organization
DIANE SEREX-DOUGAN, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE R SEREX-DOUGAN O.D. (OPTOMETRIST)
(443) 629-5459
Entity
Organization
Contact information
Practice address
7954 HARFORD RD, BALTIMORE, MD 21234-5838
(443) 629-5459
Mailing address
7954 HARFORD RD, BALTIMORE, MD 21234-5838
(443) 629-5459
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
TAO849
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154300309
NPI
—
Enumeration date
06/06/2018
Last updated
06/06/2018
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