Individual
DR. MICHAEL GRUNDEL ISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113
Mailing address
16223 COLUMBUS AVE, DERWOOD, MD 20855-2188
(617) 306-1260
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0101230684
VA
207RI0200X
Infectious Disease Physician
221230
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5862540
—
VA
Enumeration date
06/08/2005
Last updated
07/08/2024
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