Organization
NORTHERN VIRGINIA VISION CENTER, INC.
Active
Other names
The Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
AYMAN BOUTROS M.D. (PRESIDENT/OWNER)
(703) 430-4400
Entity
Organization
Contact information
Practice address
21475 RIDGETOP CIRCLE, SUITE 300, STERLING, VA 20166-6580
(703) 430-4400
(703) 430-4130
Mailing address
21475 RIDGETOP CIR, SUITE 300, STERLING, VA 20166-6580
(703) 430-4400
(703) 430-4130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618-000230
VA
207W00000X
Ophthalmology Physician
0101-043806
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0858550001
DEMERC STERLING OFFICE
VA
01
—
0858550002
DEMERC ALEXANDRIA OFFICE
VA
01
—
0858550003
DEMERC FAIRFAX OFFICE
VA
01
—
0858550004
DEMERC LEESBURG OFFICE
VA
01
—
4147
BCBS NCA/CAPITAL CARE
DC
05
—
8956502
—
MD
Enumeration date
10/19/2006
Last updated
06/21/2018
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