Individual
DR. GENE SWEETNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5204A ROLLING RD, BURKE PROFESSIONAL CENTER, BURKE, VA 22015-1605
(703) 425-2000
(703) 425-2003
Mailing address
5204A ROLLING RD, BURKE PROFESSIONAL CENTER, BURKE, VA 22015-1605
(703) 425-2000
(703) 425-2003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000626
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618000626
VIRGINIA LICENSE NUMBER
VA
Enumeration date
04/28/2006
Last updated
11/23/2007
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