Individual
MARY KAY DINEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12700 MCMANUS BLVD, SUITE 102 A, NEWPORT NEWS, VA 23602-4407
(757) 874-8696
(757) 872-9904
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 594-2195
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
0101034565
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477550671
—
VA
Enumeration date
07/01/2005
Last updated
04/02/2009
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