Provider Demographics
NPI:1669486569
Name:DILZER, ANNETTE F (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:F
Last Name:DILZER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2818
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20134-4818
Mailing Address - Country:US
Mailing Address - Phone:540-338-1833
Mailing Address - Fax:
Practice Address - Street 1:530 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3171
Practice Address - Country:US
Practice Address - Phone:540-338-1833
Practice Address - Fax:540-338-3791
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000662152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU63434Medicare UPIN