Provider Demographics
NPI:1386942548
Name:MAXIMEYES INC
Entity type:Organization
Organization Name:MAXIMEYES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINU
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-302-6336
Mailing Address - Street 1:381 STUYVESANT ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2400
Mailing Address - Country:US
Mailing Address - Phone:540-347-2217
Mailing Address - Fax:540-686-7466
Practice Address - Street 1:381 STUYVESANT ST
Practice Address - Street 2:SUITE #2
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2400
Practice Address - Country:US
Practice Address - Phone:540-347-2217
Practice Address - Fax:540-686-7466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty