Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 0101230973 | VA |
NPI | 1144335308 |
---|---|
Provider Name | Dr. Patrick William Mason |
First Address | Fairfax, VA 22031-2238 |
Second Address | Fairfax, VA 22031-2238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6720412 | (05) | VA |
H01626 | (02) | VA |