Individual
DR. GIOVANNI DISANDRO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
885 KEMPSVILLE RD STE 101, NORFOLK, VA 23502-3800
(757) 461-1444
(757) 461-8238
Mailing address
885 KEMPSVILLE ROAD, SUITE 101, NORFOLK, VA 23502-3800
(757) 461-1444
(757) 461-8238
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101254154
VA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
0101254154
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-019
TRICARE/CHAMPUS
VA
01
—
10116316
OPTIMA HEALTH
VA
01
—
1497997712
VIRGINIA PREMIER HEALTH PLAN
VA
05
—
1497997712
—
NC
05
—
1497997712
—
VA
01
—
501106
ANTHEM BC/BS
VA
01
—
PAR
AETNA
VA
Enumeration date
04/01/2009
Last updated
03/20/2018
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