Individual
DR. MARY A MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1086
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0953C
BLUE CROSS & BLUE SHIELD
NC
05
—
890953C
—
NC
Enumeration date
02/06/2006
Last updated
05/24/2019
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