Provider Demographics
NPI:1366587198
Name:ENCARNACION, MARIA DOLORES (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DOLORES
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:498 FERNEY CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:VA
Mailing Address - Zip Code:24380-4653
Mailing Address - Country:US
Mailing Address - Phone:540-789-7341
Mailing Address - Fax:276-236-6370
Practice Address - Street 1:586 FERNEY CREEK RD NW
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:VA
Practice Address - Zip Code:24380-4652
Practice Address - Country:US
Practice Address - Phone:540-789-7341
Practice Address - Fax:276-236-6370
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101043241207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine