Individual
MANDISA MCIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(301) 565-4280
Mailing address
PO BOX 37215, BALTIMORE, MD 21297-3215
(301) 565-4280
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2007-01055
NC
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD043816
DC
Other
Enumeration date
08/12/2007
Last updated
05/25/2016
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