Individual
MICHELLE C DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 N GEORGE MASON DR, VIRGINIA HOSPITAL CENTER, ARLINGTON, VA 22205-3610
(703) 558-6167
(703) 558-5355
Mailing address
2813 27TH ST NW, WASHINGTON, DC 20008-4129
(202) 270-6250
(301) 921-7915
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101237831
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010171067
—
VA
Enumeration date
10/18/2005
Last updated
07/08/2007
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