Provider Demographics
NPI:1013003763
Name:DUVAL, SARAH C (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:DUVAL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E. BYRD STREET
Mailing Address - Street 2:SUITE 160A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219
Mailing Address - Country:US
Mailing Address - Phone:804-780-0359
Mailing Address - Fax:
Practice Address - Street 1:901 E. BYRD STREET
Practice Address - Street 2:SUITE 160A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-0000
Practice Address - Country:US
Practice Address - Phone:804-780-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA277196OtherANTHEM PROVIDER NUMBER