Handeland, Wallace M
Handeland, Wallace M is an individual health care provider with primary practice located at 4217 Virginia Beach Blvd , Virginia Beach VA 23452-1232. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Handeland, Wallace M can be contacted via phone (757) 340-7070.Contact Information
Primary practice address
4217 Virginia Beach Blvd
Virginia Beach VA 23452-1232
Phone: (757) 340-7070
Fax: (757) 340-7500
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 601000770 | Virginia |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 601000770 | Virginia |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 601000770 | Virginia |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 601000770 | Virginia |
Profile Details
| NPI number | 1598740581 |
|---|---|
| LBN Legal business name | Handeland, Wallace M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2005 |
| Last updated | Sep 3rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598740581 | NPPES |
| Virginia | Other | 184237 | ANTHEM BCBS |
| Virginia | Other | 51-0558604 | ANTHEM BCBS |
| Virginia | Other | 1801903745 | ANTHEM BCBS |
| Virginia | MEDICAID | 92-3020-3 | ANTHEM BCBS |
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