Individual
MARIO ANTHONY CASOLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1750 TYSONS BLVD STE 1160, TYSONS, VA 22102
(571) 341-9450
(703) 521-5991
Mailing address
1750 TYSONS BLVD STE 1160, TYSONS, VA 22102-4230
(571) 341-9450
(703) 521-5991
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0101035642
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6082777
—
VA
Enumeration date
08/23/2005
Last updated
07/23/2018
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