Provider Demographics
NPI:1578225777
Name:MARY WASHINGTON HEALTHCARE PHYSICIANS
Entity Type:Organization
Organization Name:MARY WASHINGTON HEALTHCARE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP AMD CFP
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-741-1494
Mailing Address - Street 1:2300 FALL HILL AVE STE 509
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3343
Mailing Address - Country:US
Mailing Address - Phone:540-741-2277
Mailing Address - Fax:
Practice Address - Street 1:9530 COSNER DR STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7760
Practice Address - Country:US
Practice Address - Phone:540-361-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies