Douglas J Lavenburg MD PA
Optometrist in Elkton, MD. Organization (NPI-2).
NPI number1831276385
StatusActive
Last updated in NPPESFeb 6, 2025
Details
- NPI
- 1831276385
- Entity type
- Organization (NPI-2)
- Legal business name
- Douglas J Lavenburg MD PA
- Organization subpart
- No
- Enumeration date
- Nov 1, 2006
- Certification date
- Feb 6, 2025
- Last updated
- Feb 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | C10002822 | DE | Yes |
Practice location
103 Chesapeake Blvd Ste CElkton, MD 21921-6313
Phone 410-392-6133 · Fax 410-392-4958
Mailing address
103 Chesapeake Blvd Ste CElkton, MD 21921-6313
Phone 410-392-6133 · Fax 410-392-4958
Authorized official
Douglas J Lavenburg
President
4103926133
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