Individual
DR. MICHAEL PATRICK BERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
142 LINDEN DR STE 108, WINCHESTER, VA 22601-6901
(540) 722-6200
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-008894
IL
152W00000X
Optometrist
Primary
0618002853
VA
152WC0802X
Corneal and Contact Management Optometrist
046-008894
IL
152WL0500X
Low Vision Rehabilitation Optometrist
046-008894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004923362
BC/BS PROVIDER NUMBER
IL
Enumeration date
07/13/2005
Last updated
10/24/2023
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