Mamana, John P
Mamana, John P is an individual health care provider with primary practice located at 12040 S Lakes Dr Suite 205, Reston VA 20191-1246. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mamana, John P can be contacted via phone (703) 230-6990.Contact Information
Primary practice address
12040 S Lakes Dr Suite 205
Reston VA 20191-1246
Phone: (703) 230-6990
Fax: (703) 230-6990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0101021602 | Virginia |
Profile Details
| NPI number | 1487654554 |
|---|---|
| LBN Legal business name | Mamana, John P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Mar 25th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487654554 | NPPES |
| Virginia | Other | 224013 | TRIGON KEYAD |
| Virginia | Other | 257642 | TRIGON KEYAD |
| Virginia | MEDICAID | 5820308 | TRIGON KEYAD |
| Virginia | Other | 461832 | TRIGON KEYAD |
| Virginia | Other | 505114 | TRIGON KEYAD |
| Virginia | Other | 45560004 | TRIGON KEYAD |
| Virginia | Other | 5325453-022 | TRIGON KEYAD |
| Virginia | Other | 0400438 | TRIGON KEYAD |
| Virginia | Other | 4092013 | TRIGON KEYAD |
| Virginia | Other | 541908735 | TRIGON KEYAD |
| Virginia | Other | 224013 | TRIGON KEYAD |
| Virginia | Other | 110184237 | TRIGON KEYAD |
| Virginia | Other | 723576 | TRIGON KEYAD |
| Virginia | Other | 0403501 | TRIGON KEYAD |
| Virginia | Other | 541908735 | TRIGON KEYAD |
| Virginia | Other | 541908735 | TRIGON KEYAD |
| Virginia | Other | 360386 | TRIGON KEYAD |
| Virginia | Other | 541908735 | TRIGON KEYAD |
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