Organization
RETINA CONSULTANTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT FRANK DUNDERVILL III MD (MANAGING PARTNER)
(304) 346-4400
Entity
Organization
Contact information
Practice address
331 LAIDLEY ST, STE 301, CHARLESTON, WV 25301-1605
(304) 346-4400
(304) 346-0704
Mailing address
PO BOX 3970, CHARLESTON, WV 25339-3970
(304) 346-4400
(304) 346-0704
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
002
WV
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008255000
—
WV
05
—
0939668
—
OH
05
—
65927964
—
KY
Enumeration date
06/09/2005
Last updated
07/21/2022
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