Provider Demographics
NPI:1699885202
Name:GARCIA, MARIA MERCEDES (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MERCEDES
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 KENMORE AVE
Mailing Address - Street 2:STE 514
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304
Mailing Address - Country:US
Mailing Address - Phone:703-461-3452
Mailing Address - Fax:703-461-3707
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:STE 514
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-461-3452
Practice Address - Fax:703-461-3707
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME147608207R00000X
MDD0040705207R00000X
VA0101048067207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F27084Medicare UPIN
721777Medicare ID - Type Unspecified