Provider Demographics
NPI:1720160823
Name:DAVID HARVAN
Entity Type:Organization
Organization Name:DAVID HARVAN
Other - Org Name:VIRGINIA EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-361-3434
Mailing Address - Street 1:8625 SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4515
Mailing Address - Country:US
Mailing Address - Phone:703-361-3434
Mailing Address - Fax:703-361-6252
Practice Address - Street 1:8625 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4515
Practice Address - Country:US
Practice Address - Phone:703-361-3434
Practice Address - Fax:703-361-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601002358152W00000X
VA0101033118207W00000X
VA0101046481207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC04856Medicare ID - Type Unspecified