Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101237129 | VA |
N | 111NI0900X | Internist | 0101237129 | VA |
Y | 207RA0401X | Internist - Addiction Medicine | 0101237129 | VA |
N | 207RH0002X | Hospice and Palliative Medicine | 0101237129 | VA |
NPI | 1487723011 |
---|---|
Provider Name | Mary G. Mcmasters |
First Address | Fishersville, VA 22939-2353 |
Second Address | Fishersville, VA 22939-2353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 02/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H09244 | (02) | VA |