Individual
MARK JOSEPH MANDICHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MARTHA JEFFERSON DR, CHARLOTTESVILLE, VA 22911
(434) 654-7580
(434) 654-7582
Mailing address
2313 FERNDOWN LN, KESWICK, VA 22947-9191
(434) 466-8701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101246995
VA
208M00000X
Hospitalist Physician
Primary
0101246995
VA
Other
Enumeration date
06/18/2007
Last updated
10/17/2024
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