Organization
SIRIUS EYE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WONG O.D. (OPTOMETRIST)
(703) 719-9110
Entity
Organization
Contact information
Practice address
6506 LOISDALE RD, ATTN: DR. MICHAEL WONG, SIRIUS EYE CARE PLLC, SPRINGFIELD, VA 22150-1824
(703) 719-9110
Mailing address
6506 LOISDALE RD, SPRINGFIELD, VA 22150-1824
(703) 719-9110
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002068
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191465
MEDICARE
VA
05
—
191465
—
VA
Enumeration date
06/20/2012
Last updated
06/20/2012
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