Individual
JEFFREY P DILISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1625 N GEORGE MASON DR, SUITE 425, ARLINGTON, VA 22205-3683
(703) 717-4400
(703) 717-4401
Mailing address
1625 N GEORGE MASON DR, SUITE 425, ARLINGTON, VA 22205-3683
(703) 717-4400
(703) 717-4401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101245481
VA
207R00000X
Internal Medicine Physician
2006-01167
NC
207R00000X
Internal Medicine Physician
MA08492700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006-01167
MEDICAL LICENSE
NC
05
—
5904418
—
NC
01
—
MA08492700
MEDICAL LICENSE
NJ
Enumeration date
07/28/2006
Last updated
03/22/2010
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