Provider Demographics
NPI:1972583565
Name:MAWHINNEY, JEFFREY PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAUL
Last Name:MAWHINNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DERMATOLOGY, DEWITT HOSPITAL
Mailing Address - Street 2:9501 FARRELL ROAD
Mailing Address - City:FT. BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060
Mailing Address - Country:US
Mailing Address - Phone:703-805-0383
Mailing Address - Fax:703-805-0189
Practice Address - Street 1:DERMATOLOGY, DEWITT HOSPITAL
Practice Address - Street 2:9501 FARRELL ROAD
Practice Address - City:FT. BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060
Practice Address - Country:US
Practice Address - Phone:703-805-0383
Practice Address - Fax:703-805-0189
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000256207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology