Individual
DR. JOSEPH DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3325 SHALLOWFORD RD STE 200, MARIETTA, GA 30062
(770) 999-0804
Mailing address
3225 SHALLOWFORD RD STE 200, MARIETTA, GA 30062-1288
(770) 999-0703
(770) 999-0814
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
01669
MD
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001323
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003258042C
—
GA
Enumeration date
07/01/2013
Last updated
07/09/2025
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