Provider Demographics
NPI:1952502056
Name:MCGRATH, MARY ELIZABETH (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:MCGRATH
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Gender:F
Credentials:CFNP
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Mailing Address - Street 1:12040 S LAKES DR
Mailing Address - Street 2:STE 190
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1246
Mailing Address - Country:US
Mailing Address - Phone:703-464-0686
Mailing Address - Fax:703-464-0698
Practice Address - Street 1:12040 S LAKES DR
Practice Address - Street 2:STE 190
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1245
Practice Address - Country:US
Practice Address - Phone:703-464-0686
Practice Address - Fax:703-464-0698
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0017137045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine