Organization
INCAREMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINSON M DISANTO D.O. (MEDICAL DIRECTOR)
(866) 397-2104
Entity
Organization
Contact information
Practice address
1325 SATELLITE BLVD NW, SUWANEE, GA 30024-4651
(866) 397-2104
Mailing address
1325 SATELLITE BLVD NW, SUWANEE, GA 30024-4651
(866) 397-2104
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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