Individual
MR. CHARLES R MUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD.
Contact information
Practice address
5701 GREENBELT RD, BERWYN HEIGHTS, MD 20740-2257
(301) 345-2053
(301) 441-1752
Mailing address
5701 GREENBELT RD, BERWYN HEIGHTS, MD 20740-2257
(301) 345-2053
(301) 441-1752
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TAO866
MD
152WV0400X
Vision Therapy Optometrist
TAO866
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091730300
—
MD
01
—
1003325
AETNA
MD
01
—
271019
MAMSI/ALLIANCE
MD
01
—
89160003
BC/BS
DC
Enumeration date
05/12/2006
Last updated
12/15/2010
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