DR. MARK EDWARD MAVITY (NPI# 1841291937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841291937 |
| Entity Type | Individual |
| Full Name | DR. MARK EDWARD MAVITY |
| Credential | MD, MPH |
| Practice Address |
11 Medical Group 238 Brookley Avenue Bolling Afb DC 20332-0001 |
| Mailing Address |
9105 Bramble Pl Annandale VA 22003-4015 |
| Practice Telephone | 2024045866 |
| Mailing Telephone | 7037641736 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
MD066025L | PA | Allopathic & Osteopathic Physicians |
| X | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
MD066025L | PA | Allopathic & Osteopathic Physicians |
| Street Address |
11 MEDICAL GROUP 238 BROOKLEY AVENUE |
| City | BOLLING AFB |
| State | DC |
| Zip Code | 20332-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275544405 | John Lloyd Chitwood | Physician Assistant | 238 Brookley Avenue, Bolling Afb, DC 20332 | 2006-08-11 |
| 1942438486 | John Ratnaker Mallya | Dentist | 579th Dental Squadron, Bolling Afb, Apo, AA 20332 | 2009-06-23 |
| 1710180229 | Hye Yong Choe | Student in an Organized Health Care Education/Training Program | 238 Brookley Avenue, Bolling Afb, DC 20332 | 2007-06-11 |
| 1023170263 | Alan T Smith | Dentist | 238 Brookley Ave, Bolling Afb, DC 20332 | 2006-12-14 |
| 1073591285 | Diane Ruth Smith | Nurse Practitioner | 238 Brookley Ave., Bolling Afb, DC 20332-0001 | 2006-01-06 |
| 1699776880 | James R Abbott | Family Medicine | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2005-08-10 |
| 1497727515 | Erik John Meyers | Dentist | 238 Brookley Ave, Bolling Afb, Washington, DC 20332-0001 | 2006-02-02 |
| 1427036193 | Kurtis Lee Dean | Physician Assistant | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2006-01-04 |
| 1114917861 | George J Gerdts | Dentist | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2005-10-25 |
| 1326037797 | Jay Christopher Smith | Dentist | 238 Brookley Ave, Ste 214, Bolling Afb, DC 20332-0001 | 2005-10-19 |
| Find all providers in zip 20332 | ||||
| Taxonomy Code | 2083A0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Aerospace Medicine |
| Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962498956 | Philip Allan La Kier | Preventive Medicine | 110 Luke Ave Rm 405, Bolling Afb, DC 20032-6400 | 2005-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831271402 | Eugene Vincent Bonventre | Preventive Medicine | Pentagon Flight Medicine Clinic, 1760 Air Force Pentagon Room 4a674, Washington, DC 20330-1760 | 2006-10-20 |
| 1891767612 | Joseph D Piorkowski Jr. | Preventive Medicine | 910 17th St Nw, Suite 800, Washington, DC 20006-2601 | 2006-02-06 |
| 1487634333 | Dwight Cator Fulton | Preventive Medicine | 914 Charles Morris Court Se, Military Sealift Command, Washington Navy Yard, Washington, DC 20398-5540 | 2006-01-18 |
| 1417930017 | George Joseph Mckenna | Preventive Medicine | Veterans Affairs Medical Ctr, 50 Irving Street, N.w., Washington, DC 20422-0001 | 2005-11-28 |
| 1669460556 | George Peach Taylor Jr. | Preventive Medicine | Hq Usaf/sg, 1780 Air Force Pentagon, Washington, DC 20330-1780 | 2005-10-13 |
| 1649265216 | James Gordon Roudebush | Preventive Medicine | 110 Luke Ave, Suite 400, Bolling Air Force Base, DC 20032-7050 | 2005-09-20 |
| 1811981871 | Vincent Joel Michaud | Preventive Medicine | 300 E St Sw, Washington, DC 20546 | 2005-09-07 |
| 1386876209 | Colleen A Annes | Preventive Medicine | Dilorenzo Tricare Health Clinic, 5801 Army Pentagon, Washington, DC 20310-0001 | 2009-08-11 |
| 1295714236 | Dana Thomas | Preventive Medicine | 2100 2nd St Sw, Cg-1133, Room 5308, Washington, DC 20593-0001 | 2006-01-10 |
| 1437135183 | Ricky Malone | Preventive Medicine | 6900 Georgia Ave Nw, Washington, Washington, DC 20307-5001 | 2005-12-15 |
| Find all providers with the same taxonomy | ||||
| City | BOLLING AFB |
| Zip Code | 20332 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.