Mamana, John P

Mamana, John P is an individual health care provider with primary practice located at 12040 S Lakes Dr Suite 205, Reston VA 20191-1246. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mamana, John P can be contacted via phone (703) 230-6990.

Contact Information

Primary practice address
12040 S Lakes Dr Suite 205 Reston VA 20191-1246
Phone: (703) 230-6990
Fax: (703) 230-6990
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101021602 Virginia

Profile Details

NPI number 1487654554
LBN Legal business name Mamana, John P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Mar 25th, 2010 - about 14 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 1487654554 NPPES
Virginia Other 224013 TRIGON KEYAD
Virginia Other 257642 TRIGON KEYAD
Virginia MEDICAID 5820308 TRIGON KEYAD
Virginia Other 461832 TRIGON KEYAD
Virginia Other 505114 TRIGON KEYAD
Virginia Other 45560004 TRIGON KEYAD
Virginia Other 5325453-022 TRIGON KEYAD
Virginia Other 0400438 TRIGON KEYAD
Virginia Other 4092013 TRIGON KEYAD
Virginia Other 541908735 TRIGON KEYAD
Virginia Other 224013 TRIGON KEYAD
Virginia Other 110184237 TRIGON KEYAD
Virginia Other 723576 TRIGON KEYAD
Virginia Other 0403501 TRIGON KEYAD
Virginia Other 541908735 TRIGON KEYAD
Virginia Other 541908735 TRIGON KEYAD
Virginia Other 360386 TRIGON KEYAD
Virginia Other 541908735 TRIGON KEYAD

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