Provider Demographics
NPI:1598380743
Name:MD EYE & FACE, LLC
Entity Type:Organization
Organization Name:MD EYE & FACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARAG
Authorized Official - Middle Name:D
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS
Authorized Official - Phone:336-793-7509
Mailing Address - Street 1:2 BELLEMORE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1313
Mailing Address - Country:US
Mailing Address - Phone:336-793-7509
Mailing Address - Fax:978-506-2062
Practice Address - Street 1:9110 PHILADELPHIA RD STE 108
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4323
Practice Address - Country:US
Practice Address - Phone:410-517-7957
Practice Address - Fax:833-944-1871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689611691OtherINDIVIDUAL NPI