Organization
CATONSVILLE EYE GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBIRAH EDLOW (ADMINISTRATOR)
(410) 747-1221
Entity
Organization
Contact information
Practice address
611 FREDERICK RD, STE 101, CATONSVILLE, MD 21228-4779
(410) 747-1221
Mailing address
611 FREDERICK RD, STE 101, CATONSVILLE, MD 21228-4779
(410) 747-1221
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA0745
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0923640001
DMERC A DME REGION A
MD
01
—
CB8388
RAILROAD MEDICARE
MD
01
—
X195R
CAREFIRST BCBS
MD
Enumeration date
06/28/2005
Last updated
12/10/2007
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