Provider Demographics
NPI:1669761649
Name:MAY, MICHELLE ANN (OD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:MAY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:331 GAMBRILLS RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1141
Mailing Address - Country:US
Mailing Address - Phone:410-923-3672
Mailing Address - Fax:410-923-4350
Practice Address - Street 1:331 GAMBRILLS RD
Practice Address - Street 2:SUITE 3
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1141
Practice Address - Country:US
Practice Address - Phone:410-923-3672
Practice Address - Fax:410-923-4350
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDTA2234152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy