Individual
MARY ELIZABETH NOONAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
314 FAIRY STREET EXT STE A, MARTINSVILLE, VA 24112-1913
(276) 638-5437
(276) 666-6686
Mailing address
314 FAIRY STREET EXT STE A, MARTINSVILLE, VA 24112-1913
(276) 638-5437
(276) 666-6686
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101240119
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000763056C/D/E
—
GA
05
—
3001601162002
—
VA
Enumeration date
01/20/2006
Last updated
04/17/2024
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