Provider Demographics
NPI:1861492852
Name:MACKIE, BARBARA M (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:M
Last Name:MACKIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:311 MAPLE AVE W
Mailing Address - Street 2:H
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4309
Mailing Address - Country:US
Mailing Address - Phone:703-938-5660
Mailing Address - Fax:703-242-8712
Practice Address - Street 1:311 MAPLE AVE W
Practice Address - Street 2:H
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4309
Practice Address - Country:US
Practice Address - Phone:703-938-5660
Practice Address - Fax:703-242-8712
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048568207Q00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF4929Medicare UPIN