Individual
GRACE MANG YUET MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
19500 SANDRIDGE WAY, SUITE 420, LEESBURG, VA 20176
(571) 375-8601
Mailing address
PO BOX 744785, ATLANTA, GA 30374-4785
(202) 476-5000
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
0101266910
VA
2085P0229X
Pediatric Radiology Physician
MD047380
DC
Other
Enumeration date
05/19/2012
Last updated
05/24/2023
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