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Individual

DR. MARK DAVID RODAMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2514 LANGHORNE RD, LYNCHBURG, VA 24501-1602
(434) 239-2800
Mailing address
2514 LANGHORNE RD, LYNCHBURG, VA 24501-1602
(434) 239-2800

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001308
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009235612
VA
05
010257468
VA
01
189926
ANTHEM BCBS-WAYNESB PROV#
VA
Enumeration date
05/04/2006
Last updated
08/06/2012
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