Provider Demographics
NPI:1932202041
Name:REEVES, MONICA L (OD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:REEVES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:L
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:3603 DAVIS DR STE 100
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6009
Practice Address - Country:US
Practice Address - Phone:919-234-4888
Practice Address - Fax:919-234-4890
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2044152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093VJOtherBLUE CROSS
NC5905078Medicaid
P01076627OtherRAILROAD MEDICARE
NC093VJOtherBLUE CROSS
NC2474304CMedicare PIN
NC2474304DMedicare PIN
P01076627OtherRAILROAD MEDICARE