Provider Demographics
NPI:1720074636
Name:STOKVIS, MONROE S (OD)
Entity Type:Individual
Prefix:DR
First Name:MONROE
Middle Name:S
Last Name:STOKVIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 ROCKVILLE PIKE
Mailing Address - Street 2:#910
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3359
Mailing Address - Country:US
Mailing Address - Phone:301-493-9025
Mailing Address - Fax:
Practice Address - Street 1:7505 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6970
Practice Address - Country:US
Practice Address - Phone:301-434-6400
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0531152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
175883Medicare ID - Type Unspecified
T30986Medicare UPIN