M. F. Diffendall Od PA

NPI #1194074476 in Phoenix, Maryland

Provider Information

NPI Number: 1194074476
Entity Type: Organization
Organization Name: M. F. Diffendall Od PA
Primary Specialty: Optometrist
Enumeration Date: Sep 2, 2012
Last Updated: Nov 14, 2013

Practice Location

Address: 3332 PAPER MILL RD
City: Phoenix
State: Maryland
ZIP Code: 21131-1419
Phone: (410) 628-1510

Authorized Official

Name: MICHAEL F DIFFENDALL, OD
Title: OWNER
Phone: (410) 628-1510

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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