Provider Demographics
NPI:1386992220
Name:JOYCE, MICHAEL LAWRENCE (OD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LAWRENCE
Last Name:JOYCE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 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:
Mailing Address - Fax:
Practice Address - Street 1:22 MCINTYRE SQUARE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7301
Practice Address - Country:US
Practice Address - Phone:412-364-4700
Practice Address - Fax:412-364-4628
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002703152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0934YOtherBCBS
NC5922295Medicaid
NCNC9197FMedicare PIN
NCNC9197IMedicare PIN
NCNC9197DMedicare PIN
NCNC9197GMedicare PIN
NCNC9197HMedicare PIN
NCNC9197EMedicare PIN
NC0934YOtherBCBS
NCNC9197KMedicare PIN
NCNC9197AMedicare PIN
NC5922295Medicaid
NCNC9197CMedicare PIN
NCNC9197BMedicare PIN