| NPI | 1962053306 |
|---|---|
| Doing Business As | MOUNT VERNON INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | COURTNEY AINSWORTH IVESS Associate Director, Credentialing 571-366-8831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2020-03-05 |