Provider Demographics
NPI:1851566319
Name:MAYFIELD, ALAN GARLAND (PA)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:GARLAND
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20752 DEWBERRY CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4642
Mailing Address - Country:US
Mailing Address - Phone:703-738-6382
Mailing Address - Fax:
Practice Address - Street 1:20752 DEWBERRY CT
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4642
Practice Address - Country:US
Practice Address - Phone:703-738-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant