Individual
DR. MATTHEW DAVID VIZITHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
200 W WEAVER ST, SUITE 1, CARRBORO, NC 27510-6009
(919) 968-6300
(919) 968-0403
Mailing address
704 W MAIN ST, CARRBORO, NC 27510
(919) 968-6300
(919) 968-0403
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1873183
UNITED HEALTH CARE MPIN
NC
01
—
396884
MAMSI
NC
05
—
89093K8
—
NC
Enumeration date
07/21/2006
Last updated
04/19/2012
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