Individual
MRS. COURTNEY F MANDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-1082
(434) 924-5700
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0110006611
VA
363A00000X
Physician Assistant
Primary
0110006611
VA
363AM0700X
Medical Physician Assistant
0110006611
VA
Other
Enumeration date
04/04/2019
Last updated
08/29/2024
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