Individual
MR. MICHAEL ANTHONY DISIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH, MPAS, PA-C
Contact information
Practice address
3501 LAFAYETTE BLVD, FREDERICKSBURG, VA 22408-4130
(540) 371-7118
(540) 371-3248
Mailing address
10805 CEDAR CREEK DR, SPOTSYLVANIA, VA 22551-4689
(540) 412-9558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1070430
—
Other
Enumeration date
12/09/2005
Last updated
03/09/2015
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