Organization
CAPITAL NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC P DIFAZIO MD (PRESIDENT)
(301) 309-2211
Entity
Organization
Contact information
Practice address
2730 PROSPERITY AVE STE B, FAIRFAX, VA 22031-4330
(703) 289-1450
(703) 289-1414
Mailing address
9715 MEDICAL CENTER DR, SUITE 414, ROCKVILLE, MD 20850-3320
(301) 309-2211
(301) 217-9303
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D0062946
MD
Other
Enumeration date
11/20/2006
Last updated
08/31/2007
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