Provider Demographics
NPI:1801965447
Name:PRESTON, MARY B (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:B
Last Name:PRESTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 COURT SQ
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5141
Mailing Address - Country:US
Mailing Address - Phone:434-960-6107
Mailing Address - Fax:
Practice Address - Street 1:661 UNIVERSITY LN STE B
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-2243
Practice Address - Country:US
Practice Address - Phone:540-661-3004
Practice Address - Fax:434-244-4508
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine