Provider Demographics
NPI:1417031675
Name:SGL INC
Entity Type:Organization
Organization Name:SGL INC
Other - Org Name:DRS SCHWARTZ AND SPIND
Other - Org Type:Other Name
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-766-3200
Mailing Address - Street 1:1600 CRAIN HWY S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5577
Mailing Address - Country:US
Mailing Address - Phone:410-766-3200
Mailing Address - Fax:410-553-9756
Practice Address - Street 1:1600 CRAIN HWY S
Practice Address - Street 2:SUITE 102
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5577
Practice Address - Country:US
Practice Address - Phone:410-766-3200
Practice Address - Fax:410-553-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1325152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1132280001Medicare NSC
MD958MMedicare PIN