Provider Demographics
NPI:1801088612
Name:SUTARIA, MEERA (OD)
Entity type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:SUTARIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MEERA
Other - Middle Name:
Other - Last Name:DADHANIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3600 S GLEBE RD
Mailing Address - Street 2:UNIT 227
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2365
Mailing Address - Country:US
Mailing Address - Phone:703-203-9656
Mailing Address - Fax:
Practice Address - Street 1:3600 S GLEBE RD
Practice Address - Street 2:UNIT 227
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-2365
Practice Address - Country:US
Practice Address - Phone:703-203-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2008-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist