Provider Demographics
| NPI: | 1295999852 |
|---|---|
| Name: | MARY WASHINGTON HEALTHCARE PHYSICIANS |
| Entity type: | Organization |
| Organization Name: | MARY WASHINGTON HEALTHCARE PHYSICIANS |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CHRISTOPHER |
| Authorized Official - Middle Name: | D |
| Authorized Official - Last Name: | NEWMAN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 540-741-3248 |
| Mailing Address - Street 1: | 2300 FALL HILL AVE |
| Mailing Address - Street 2: | SUITE 509 |
| Mailing Address - City: | FREDERICKSBURG |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 22401-3342 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 540-741-1821 |
| Mailing Address - Fax: | 540-741-1097 |
| Practice Address - Street 1: | 1001 SAM PERRY BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | FREDERICKSBURG |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 22401-4453 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 540-741-1100 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-07-14 |
| Last Update Date: | 2025-11-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 2086S0122X | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery | Group - Multi-Specialty |
| No | 2086S0127X | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
| No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| VA | 1295999852 | Medicaid | |
| VA | 1295999852 | Medicaid |