Individual
DR. DARIA KISELICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
2500 INVESTIGATION PKWY, QUANTICO, VA 22134-5173
(703) 632-5084
Mailing address
2500 INVESTIGATION PKWY, QUANTICO, VA 22134-5173
(703) 632-5084
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
0101042017
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010195837
—
VA
01
—
1000870001
DME PROVIDER
VA
01
—
189326
ANTHEM/BCBS
—
01
—
321001
SOUTHERN HEALTH
—
01
—
5597393
CIGNA
VA
01
—
71513000
WV MEDICAID
WV
01
—
93459
OPTIMA
VA
Enumeration date
04/14/2006
Last updated
02/26/2013
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