Provider Demographics
NPI:1174601421
Name:BOND, NATHAN PATRICK (OD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:PATRICK
Last Name:BOND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4554 VIRGINIA BEACH BLVD
Mailing Address - Street 2:STE. 830 PEMBROKE MALL
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3045
Mailing Address - Country:US
Mailing Address - Phone:757-497-3205
Mailing Address - Fax:757-490-3794
Practice Address - Street 1:4554 VIRGINIA BEACH BLVD
Practice Address - Street 2:STE. 830 PEMBROKE MALL
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3045
Practice Address - Country:US
Practice Address - Phone:757-497-3205
Practice Address - Fax:757-490-3794
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000486152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist