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Individual

DR. JOHN P MAMANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12040 S LAKES DR, SUITE 205, RESTON, VA 20191-1246
(703) 230-6990
(703) 230-6990
Mailing address
12040 S LAKES DR, SUITE205, RESTON, VA 20191-1246
(703) 230-6990
(703) 230-0350

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101021602
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0400438
UNITED HEALTH VIRGINIA
VA
01
0403501
UNITED HEALTH MID-ATLANTI
VA
01
110184237
RAILROAD MEDICARE
VA
01
224013
TRIGON KEYAD
VA
01
257642
MDIPA/OPTIMUM CHOICE/MAMS
VA
01
360386
ONE HEALTH GREATWEST
VA
01
4092013
AHP MGD CHOICE
VA
01
45560004
BCBS DC CAPCARE
VA
01
461832
AETNA/US HEALTHCARE
VA
01
505114
NCPPO
VA
01
5325453-022
CIGNA HMO
VA
01
541908735
PREFERRED PLAN
VA
05
5820308
VA
01
723576
AFFORDABLE FIRST HEALTH
VA
Enumeration date
07/29/2005
Last updated
03/25/2010
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