Provider Demographics
NPI:1659300945
Name:MISERA, JOSEPH M (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:MISERA
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:305 LILYS WAY
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-7659
Mailing Address - Country:US
Mailing Address - Phone:540-662-5599
Mailing Address - Fax:540-662-5768
Practice Address - Street 1:1850 APPLE BLOSSOM DR
Practice Address - Street 2:#S105
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5187
Practice Address - Country:US
Practice Address - Phone:540-662-5599
Practice Address - Fax:540-662-5768
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000604152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU63497Medicare UPIN