Organization
CHESAPEAKE EYE CARE & LASER CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK VAUGHN (CREDENTIALING SPECIALIST)
(410) 571-8733
Entity
Organization
Contact information
Practice address
11637 TERRACE DR STE 103, WALDORF, MD 20602-3707
(410) 571-8733
Mailing address
2661 RIVA RD STE 1030, ANNAPOLIS, MD 21401-7131
(410) 571-8733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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