Organization
M&D OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M WANICUR M.D. (OWNER)
(301) 770-4310
Entity
Organization
Contact information
Practice address
501 N FREDERICK AVE, GAITHERSBURG, MD 20877-2507
(301) 926-3933
(301) 881-2945
Mailing address
501 N FREDERICK AVE, GAITHERSBURG, MD 20877-2507
(301) 926-3933
(301) 881-2945
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548307309
NPI
MD
Enumeration date
01/31/2007
Last updated
08/27/2008
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