Individual
DR. JOHN D. MANDEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1965 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-6213
(540) 735-0560
Mailing address
1965 JEFFERSON DAVIS HWY, ATTN: MANAGED CARE PLANNING, FREDERICKSBURG, VA 22401-6213
(540) 735-0560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102204737
VA
207Q00000X
Family Medicine Physician
2014-01055
NC
Other
Enumeration date
03/21/2008
Last updated
01/03/2017
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