Carol Jean Mack, P.A.-C
Physician Assistant in Washington, DC. Individual provider (NPI-1).
NPI number1235207366
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1235207366
- Entity type
- Individual (NPI-1)
- Name
- Ms. Carol Jean Mack
- Credential
- P.A.-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 30, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA30161 | DC | Yes |
Practice location
1850 M St NwSuite 450
Washington, DC 20036-5803
Phone 202-293-1000
Mailing address
1106 Norris Ct SwLeesburg, VA 20175-4361
Phone 703-669-9343
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