Provider Demographics
NPI:1861187957
Name:MCINTYRE, MARY A
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 FONTAINEBLEU DR
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3841
Mailing Address - Country:US
Mailing Address - Phone:301-640-8572
Mailing Address - Fax:
Practice Address - Street 1:1046 QUEBEC PL NW # 20010
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1418
Practice Address - Country:US
Practice Address - Phone:202-425-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty