| NPI | 1548201247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD FAROOQ ANWAR Owner 304-845-0908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 00060) |
| Additional Taxonomies | 152W00000X Optometrist |
| 207R00000X Internal Medicine | |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2012-04-10 |