Provider Demographics
NPI:1861683872
Name:EYE TO EYE OF FREDERICK INC
Entity Type:Organization
Organization Name:EYE TO EYE OF FREDERICK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-695-8771
Mailing Address - Street 1:2060 YELLOW SPRINGS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2322
Mailing Address - Country:US
Mailing Address - Phone:301-695-8771
Mailing Address - Fax:301-695-1616
Practice Address - Street 1:2060 YELLOW SPRINGS RD STE 104
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2322
Practice Address - Country:US
Practice Address - Phone:301-695-8771
Practice Address - Fax:301-695-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA 858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty