Individual
DR. RONALD ENRICO DISIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1705 WARREN AVE, SUITE 101-103, WILLIAMSPORT, PA 17701-2647
(570) 321-2020
(570) 320-7576
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD029691-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010866270001
—
PA
01
—
489816
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/24/2005
Last updated
08/18/2016
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