Provider Demographics
NPI:1750109021
Name:MUSIE, RAIT (OD)
Entity type:Individual
Prefix:DR
First Name:RAIT
Middle Name:
Last Name:MUSIE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20142 PRAIRIE DUNES TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3192
Mailing Address - Country:US
Mailing Address - Phone:571-236-9907
Mailing Address - Fax:
Practice Address - Street 1:220 CHAMPION DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6665
Practice Address - Country:US
Practice Address - Phone:301-791-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618003429152W00000X
MD3039152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist