Provider Demographics
NPI:1891905253
Name:ADAIR, EDWIN ROSS III (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:ROSS
Last Name:ADAIR
Suffix:III
Gender:M
Credentials:OD
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Mailing Address - Street 1:5718 UNION MILL RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-1088
Mailing Address - Country:US
Mailing Address - Phone:703-830-3977
Mailing Address - Fax:703-830-0714
Practice Address - Street 1:5718 UNION MILL RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-1088
Practice Address - Country:US
Practice Address - Phone:703-830-3977
Practice Address - Fax:703-830-0714
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2010-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA161748935Medicare UPIN
VA183485Medicare PIN