| Dr Nicholas E Bem, OD | |
|
27th Special Operations Medical Group, 224 W D.l. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103 | |
| (575) 904-3881 | |
| Not Available |
| Full Name | Dr Nicholas E Bem |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 27th Special Operations Medical Group, Cannon Afb, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164823142 | NPI | - | NPPES |
| 11106297-9934 | Other | UT | STATE OF UTAH DEPARTMENT OF COMMERCE |
| 2376 | Other | NC | NC BOARD OF OPTOMETRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 11106297-9934 (Utah) | Primary |
| Provider Name | Eyecarecenter Od Pa |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1417973546 PECOS PAC ID: 7315834462 Enrollment ID: O20040318001780 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Nicholas E Bem, OD 27th Special Operations Medical Group, 224 W D.l. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103 Ph: () - | Dr Nicholas E Bem, OD 27th Special Operations Medical Group, 224 W D.l. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103 Ph: (575) 904-3881 |
Vista Optical Optometrist Medicare: Not Enrolled in Medicare Practice Location: 102 W Octagon St, Bldg 77b, Cannon Afb, NM 88103 Phone: 575-904-1001 Fax: 575-784-9722 | |
Jason P Nolz, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 208 W Dl Ingram Ave, Cannon Afb, NM 88103 Phone: 575-784-6608 |