Healthcare Provider Details

I. General information

NPI: 1497181861
Provider Name (Legal Business Name): REBECCA ANNE MAHONY-WOOD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 M STREET NW
WASHGINTON DC
20037
US

IV. Provider business mailing address

2300 M ST NW FL 5
WASHINGTON DC
20037-1597
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3300
  • Fax:
Mailing address:
  • Phone: 202-741-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA200001527
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0005163
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: