Provider Demographics
NPI:1255345096
Name:MCMACKIN, CHRISTOPHER MULLANY (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MULLANY
Last Name:MCMACKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 M ST NW
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1445
Mailing Address - Country:US
Mailing Address - Phone:202-296-0043
Mailing Address - Fax:202-296-1306
Practice Address - Street 1:2311 M ST NW
Practice Address - Street 2:SUITE 302
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1445
Practice Address - Country:US
Practice Address - Phone:202-296-0043
Practice Address - Fax:202-296-1306
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC16615207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC025969800Medicaid
DCE63771Medicare UPIN
DC025969800Medicaid