Individual
MICHAEL A DIMEOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
160 ALLEN ST, RUTLAND, VT 05701-4560
(802) 747-1739
Mailing address
160 ALLEN ST, RUTLAND, VT 05701-4560
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
P4751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321339903
—
TX
Enumeration date
07/03/2008
Last updated
05/30/2019
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