Individual
DR. MAURIZIO LORENZO GHISOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 FOREST LN STE D400, DALLAS, TX 75230-6899
(972) 566-6647
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
N2528
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203924001
—
TX
05
—
203924002
—
TX
05
—
203924003
—
TX
01
—
P00930576
RAILROAD MEDICARE
TX
Enumeration date
05/04/2009
Last updated
12/15/2017
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