Organization
DVC OF VIRGINIA PC
Active
Other names
Doctors Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
TINA M BURGESS (CREDENTIALING SPECIALIST)
(252) 442-0802
Entity
Organization
Contact information
Practice address
540 LEW DEWITT BOULEVARD, SUITE 5, WAYNESBORO, VA 22980
(540) 943-7486
(540) 942-2251
Mailing address
540 LEW DEWITT BOULEVARD, SUITE 5, WAYNESBORO, VA 22980
(540) 943-7486
(540) 942-2251
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010257468
—
VA
01
—
189926
ANTHEM BCBS
VA
01
—
DG0209
WAY GROUP RRMCR NUMBER
VA
01
—
P00753364
NOWAK RRMCR INDIVIDUAL NUMBER
VA
Enumeration date
05/04/2006
Last updated
11/20/2009
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