Individual
SANDRA M DELISTATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4701 SANGAMORE RD, UNITE N270, BETHESDA, MD 20816-2508
(240) 507-5110
Mailing address
8201 BURNING TREE RD, BETHESDA, MD 20817-2908
(301) 469-6263
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0059980
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415096100
—
MD
Enumeration date
10/31/2005
Last updated
04/10/2017
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