Provider Demographics
NPI:1194843979
Name:MID-ATLANTIC GLAUCOMA EXPERTS, LLC
Entity Type:Organization
Organization Name:MID-ATLANTIC GLAUCOMA EXPERTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-377-2422
Mailing Address - Street 1:6115 FALLS RD
Mailing Address - Street 2:SUITE 333
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2219
Mailing Address - Country:US
Mailing Address - Phone:410-377-2422
Mailing Address - Fax:410-377-7960
Practice Address - Street 1:6115 FALLS RD
Practice Address - Street 2:SUITE 333
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2219
Practice Address - Country:US
Practice Address - Phone:410-377-2422
Practice Address - Fax:410-377-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060726207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty