Individual provider · Type 1 NPI
Destiny L. Mack
Medical Physician Assistant · Washington, DC
NPI number
1629677398
Active
Practice location
900 23rd St NW
Washington, DC 20037-2342
Fax (202) 715-4015
Mailing address
2309 Shorefield Rd Apt 122
Silver Spring, MD 20902-1853
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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About NPI 1629677398
Destiny L. Mack's National Provider Identifier is 1629677398, issued on Oct 22, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Washington, DC. The record was last updated on Oct 5, 2021.