Provider Demographics
NPI:1346681749
Name:OVERMEYER, MARTHA KALASKY (OD)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:KALASKY
Last Name:OVERMEYER
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 GEORGE WASHINGTON MEM HWY STE V
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-4316
Mailing Address - Country:US
Mailing Address - Phone:757-978-2020
Mailing Address - Fax:757-765-6131
Practice Address - Street 1:1215 GEORGE WASHINGTON MEM HWY STE V
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-4316
Practice Address - Country:US
Practice Address - Phone:757-978-2020
Practice Address - Fax:757-765-6131
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA06180002263152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVA799AMedicare UPIN