Individual
LEA L MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7601 FOREST AVE, SUITE 100, RICHMOND, VA 23229-4933
(804) 282-9479
(804) 285-9805
Mailing address
PO BOX 79164, BALTIMORE, MD 21279-0164
(804) 282-9479
(804) 285-9805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101240049
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
0101240049
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0-010300304
—
VA
Enumeration date
07/03/2006
Last updated
05/31/2022
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