MEDICARE: MARY-KATE C MEKHAIL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101274782	VA
2	171000000X	Military Health Care Provider

General Provider Information

NPI Number	:	1063048767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY-KATE C MEKHAIL MD

Provider Business Mailing Address
First Line	:	PSC 808 BOX 19
Second Line	:
City	:	FPO
State	:	AE
Zip	:	09618-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	617-694-9052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2020
Last Update Date	:	06/05/2026

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