Provider Demographics
NPI:1770045544
Name:MARY WASHINGTON HEALTHCARE PHYSICIANS
Entity Type:Organization
Organization Name:MARY WASHINGTON HEALTHCARE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP & CFO
Authorized Official - Prefix:MR
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:540-741-1029
Practice Address - Street 1:90 GREENSPRING DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1752
Practice Address - Country:US
Practice Address - Phone:540-373-4602
Practice Address - Fax:540-310-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies