Provider Demographics
NPI:1780797647
Name:MACKIN, JAMES FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:MACKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE
Mailing Address - Street 2:SUITE 675
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-0630
Mailing Address - Country:US
Mailing Address - Phone:301-657-0802
Mailing Address - Fax:301-657-0803
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:SUITE 675
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-0630
Practice Address - Country:US
Practice Address - Phone:301-657-0802
Practice Address - Fax:301-657-0803
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037678207RE0101X
DCMD 25579207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01080Medicare ID - Type Unspecified
C87788Medicare UPIN