Individual
DR. LISA A DIMARZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2003 MEDICAL PARKWAY, SUITE 100, ANNAPOLIS, MD 21401
(410) 573-1110
(410) 266-0714
Mailing address
2003 MEDICAL PKWY, SUITE 100, ANNAPOLIS, MD 21401-7992
(410) 573-1110
(410) 266-0714
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
038158
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
BCBS
DC
01
—
0401156
UNITED HEALTHCARE
—
05
—
093371600
—
MD
01
—
110060518
MEDICARE RAILROAD
MD
01
—
1496254
UNITED MINE WORKERS ASSOC
—
01
—
260077
MDIPA
—
01
—
4269169
AETNA
—
01
—
52129501
BCBS
MD
01
—
P0409
PRINCIPLE
—
01
—
P11673
BCBS POINT OF SERVICE
—
Enumeration date
09/20/2006
Last updated
02/03/2010
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