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Individual

CATHY SOUTHAMMAKOSANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1500 N BEAUREGARD ST STE 200, ALEXANDRIA, VA 22311-1700
(703) 212-6600
(703) 931-0961
Mailing address
PO BOX 791249, BALTIMORE, MD 21279-1249
(703) 212-6600
(703) 931-0961

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101256591
VA
2084P0800X
Psychiatry Physician
MD039787
DC

Other

Enumeration date
06/04/2007
Last updated
03/06/2018
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