Provider Demographics
NPI:1508117482
Name:CHARITY EYE CARE AND SURGERY CENTER
Entity Type:Organization
Organization Name:CHARITY EYE CARE AND SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUPLESSIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-468-3030
Mailing Address - Street 1:6000 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 525
Mailing Address - City:N BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3803
Mailing Address - Country:US
Mailing Address - Phone:301-468-3030
Mailing Address - Fax:301-468-7037
Practice Address - Street 1:6000 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 525
Practice Address - City:N BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3803
Practice Address - Country:US
Practice Address - Phone:301-468-3030
Practice Address - Fax:301-468-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00052880261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery