Provider Demographics
NPI:1639173453
Name:MCVEY, BRETT DENNIS (OD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:DENNIS
Last Name:MCVEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 LEMONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3847
Mailing Address - Country:US
Mailing Address - Phone:440-233-7562
Mailing Address - Fax:
Practice Address - Street 1:209 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-1609
Practice Address - Country:US
Practice Address - Phone:440-246-2020
Practice Address - Fax:440-244-3257
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3622/T559152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0513368Medicaid
OHMC0574394 TYPE 4Medicare PIN
OH0513368Medicaid