NPI 1043696305

Ganesan Sivaguru, OD

Practitioner Optometrist Baileys Crossroads, VA

Practice location

Address: 3556a S Jefferson St, Baileys Crossroads, VA 22041-3119
Phone: (703) 379-1100
Mailing address: 201 Shannon CT, Salisbury, MD 21804-1974

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 0618002463 (VA)

Other Optometrist providers in Virginia →

Corneal and Contact Management Optometrist

Eye and Vision Services Providers Taxonomy 152WC0802X Licence 0618002463 (VA)

Registry record

NPI: 1043696305
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2015
Record last updated: 9 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.