Provider Demographics
NPI:1134400690
Name:MA, MONICA (OD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:MA
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 1:7250 O'KELLY CHAPEL ROAD
Mailing Address - Street 2:STE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519
Mailing Address - Country:US
Mailing Address - Phone:919-883-9987
Mailing Address - Fax:919-887-6381
Practice Address - Street 1:7250 O'KELLY CHAPEL ROAD
Practice Address - Street 2:STE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519
Practice Address - Country:US
Practice Address - Phone:919-883-9987
Practice Address - Fax:919-887-6381
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2242152W00000X
PAOEG002507152W00000X
MDTA2246152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist