Mahoney, David L

Mahoney, David L is an individual health care provider with primary practice located at 13135 Lee Jackson Memorial Hwy 135, Fairfax VA 22033-1907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Mahoney, David L can be contacted via phone (703) 961-0488.

Contact Information

Primary practice address
13135 Lee Jackson Memorial Hwy 135 Fairfax VA 22033-1907
Phone: (703) 961-0488
Fax: (703) 961-0480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 0101046060 Virginia

Profile Details

NPI number 1548268048
LBN Legal business name Mahoney, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Aug 11th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548268048 NPPES
Virginia MEDICAID 006040934

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