Individual
DR. RICHARD A VAN DE VELDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3215 SHRINE RD, SUITE 6, BRUNSWICK, GA 31520
(912) 267-0565
(912) 265-0545
Mailing address
3215 SHRINE RD, SUITE 6, BRUNSWICK, GA 31520
(912) 267-0565
(912) 265-0545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00912821A
—
GA
Enumeration date
08/13/2006
Last updated
03/07/2023
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