South Baltimore Eye Associtate Inc.

NPI #1003978180 in Baltimore, Maryland

Provider Information

NPI Number: 1003978180
Entity Type: Organization
Organization Name: South Baltimore Eye Associtate Inc.
Primary Specialty: Optometrist
Enumeration Date: Dec 14, 2006
Last Updated: May 17, 2011

Practice Location

Address: 1029 LIGHT ST
City: Baltimore
State: Maryland
ZIP Code: 21230-4017
Phone: (410) 752-8208

Authorized Official

Name: DR. CALVERT ROSS BREGEL JR., O.D.
Title: OWNER
Phone: (410) 752-8208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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