Provider Demographics
NPI:1699029470
Name:DR. MICHAEL VOLLMER
Entity Type:Organization
Organization Name:DR. MICHAEL VOLLMER
Other - Org Name:DR. MICHAEL VOLLMER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:VOLLMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-667-6000
Mailing Address - Street 1:1500 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-7348
Mailing Address - Country:US
Mailing Address - Phone:336-667-6000
Mailing Address - Fax:336-667-1911
Practice Address - Street 1:1500 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-7348
Practice Address - Country:US
Practice Address - Phone:336-667-6000
Practice Address - Fax:336-667-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1009152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty