Provider Demographics
NPI:1447226196
Name:MASON, MARY E (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:1168 FIRST COLONIAL RD
Practice Address - Street 2:STE 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2444
Practice Address - Country:US
Practice Address - Phone:757-496-9020
Practice Address - Fax:757-481-0638
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101043869207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA250693OtherANTHEM
NC890633YMedicaid
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherAETNA
VAPAROtherCORVEL/CORCARE
VA15578OtherSENTARA OPTIMA
VA006073026Medicaid
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA-033OtherTRICARE/CHAMPUS
NC0633YOtherBC/BS
VAPAROtherCIGNA
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VA236912OtherUHC/MAMSI
VAPAROtherVIRGINIA HEALTH NETWORK
VA236912OtherUHC/MAMSI
VA250693OtherANTHEM
VAE07784Medicare UPIN