Provider Demographics
NPI:1093853343
Name:REED, VIRGINIA ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:ELIZABETH
Last Name:REED
Suffix:
Gender:F
Credentials:OD
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Other - First Name:
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Mailing Address - Street 1:1238 SMALLWOOD DRIVE WEST
Mailing Address - Street 2:ST CHARLES TOWN PLAZA
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603
Mailing Address - Country:US
Mailing Address - Phone:301-932-4390
Mailing Address - Fax:301-932-8660
Practice Address - Street 1:1238 SMALLWOOD DRIVE WEST
Practice Address - Street 2:ST CHARLES TOWN PLAZA
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603
Practice Address - Country:US
Practice Address - Phone:301-932-4390
Practice Address - Fax:301-932-8660
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0831152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist