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Medical and Surgical Eye Care

195 Thomas Johnson Dr. Frederick, MD 21702

Phone: 1-800-778-7647 Fax: 301-363-2280

www.MarylandVisionCenter.com

• General Eye Exams

• Glaucoma

• Macular Degeneration

• Blepharitis

• Herpetic Eye Disease

• Conjunctivitis

• Fuchs Dystrophy

• Bullous Keratopathy

• Diabetic Eye Exams

• Cataract

• Dry eye

• Pterygium

• Microbial Keratitis

• Corneal Ulceration

• ABMD/RES

• Keratoconus

Patient Details:Name:

Date of Birth:

Clinical Information:

Phone :

Signature:

Referring Doctor

Please call for appointments in Martinsburg, WV

Name:

Fax:

Sunil M. Thadani M.D., M.P.H.Board Certified Ophthalmologist

Cornea Specialist

Please Indicate if Appointment is: Urgent Next Available