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General NPI Number Information
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NPI Number | 1124120316
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Entity Type | Individual
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Provider Name | PEARLINE MCKENZIE-GARNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2511 JEFFERSON DAVIS HWY NC1, 12TH FL RM 300, ATTN SAIG-TI (MEDICAL OFFICER)
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City | ARLINGTON
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State | VA
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Zip | 22202-3926
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Country | US
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Telephone | 703-601-1190
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 ANNAPOLIS RD # 224
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City | ODENTON
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State | MD
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Zip | 21113-1633
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | 0101054882
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License Number State | VA
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