Provider Demographics
NPI:1548461932
Name:O'SULLIVAN-MEJIA, EMERALD DAWN (MD)
Entity type:Individual
Prefix:DR
First Name:EMERALD
Middle Name:DAWN
Last Name:O'SULLIVAN-MEJIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9834 BUSINESS WAY
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4151
Mailing Address - Country:US
Mailing Address - Phone:703-257-1440
Mailing Address - Fax:703-257-4337
Practice Address - Street 1:4600 SPOTSYLVANIA PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7762
Practice Address - Country:US
Practice Address - Phone:540-498-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244383207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology