Individual
MS. MARY ELIZABETH DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9376 ATLEE STATION RD, MECHANICSVILLE, VA 23116-2602
(804) 730-0990
Mailing address
9376 ATLEE STATION RD, MECHANICSVILLE, VA 23116-2602
(804) 730-0990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0024169805
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001223184
RN LICENSE
VA
01
—
0024169805
NP LICENSE
VA
Enumeration date
01/03/2012
Last updated
01/03/2012
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