Provider Demographics
NPI:1629576186
Name:SARVER, MAX DANIEL
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:DANIEL
Last Name:SARVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MIDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2487
Mailing Address - Country:US
Mailing Address - Phone:813-417-4662
Mailing Address - Fax:
Practice Address - Street 1:928 NJ-73
Practice Address - Street 2:
Practice Address - City:EVESHAM TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-596-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5829152W00000X
NJ27OA00678300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist