Provider Demographics
NPI:1285621706
Name:LUTHMAN, NICHOLAS GERARD (OD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:GERARD
Last Name:LUTHMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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:709-847-8899
Mailing Address - Fax:866-795-4020
Practice Address - Street 1:2028 S PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-7000
Practice Address - Country:US
Practice Address - Phone:540-722-3217
Practice Address - Fax:540-722-3219
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.3871-THER152W00000X
VA0618000476152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist