Provider Demographics
NPI:1164678090
Name:O'MEARA, EMILY C (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:C
Last Name:O'MEARA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2525 RIVA RD
Mailing Address - Street 2:SUITE 126
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7411
Mailing Address - Country:US
Mailing Address - Phone:410-268-4393
Mailing Address - Fax:410-268-5200
Practice Address - Street 1:2525 RIVA RD
Practice Address - Street 2:SUITE 126
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7411
Practice Address - Country:US
Practice Address - Phone:410-268-4393
Practice Address - Fax:410-268-5200
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDTA2097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5700600001Medicare NSC
MD142549ZCF9Medicare PIN