Total Retina LLC

NPI #1063526713 in Baltimore, Maryland

Provider Information

NPI Number: 1063526713
Entity Type: Organization
Organization Name: Total Retina LLC
Primary Specialty: Ophthalmology
Enumeration Date: Aug 19, 2006
Last Updated: Jun 27, 2008

Practice Location

Address: 6115 FALLS RD
Address 2: SUITE 300
City: Baltimore
State: Maryland
ZIP Code: 21209-2219
Phone: (410) 377-9004

Authorized Official

Name: RANDALL V WONG, MD
Title: PRESIDENT
Phone: (410) 377-9004

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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