Provider Demographics
NPI:1164668687
Name:MAYFRANK INC
Entity Type:Organization
Organization Name:MAYFRANK INC
Other - Org Name:STERLING OPTICAL, IVERSON MALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:SUNDAY
Authorized Official - Last Name:ONWUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-245-4022
Mailing Address - Street 1:3801 BRANCH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1415
Mailing Address - Country:US
Mailing Address - Phone:301-899-1454
Mailing Address - Fax:301-702-2854
Practice Address - Street 1:3801 BRANCH AVE STE D
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1415
Practice Address - Country:US
Practice Address - Phone:301-899-1454
Practice Address - Fax:301-702-2854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1912152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WX0102X
DCOP1000092152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD020377700Medicaid