Individual
JOHN DEGRAZIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8001 FORBES PL, SUITE 103, SPRINGFIELD, VA 22151-2208
(703) 824-3200
Mailing address
PO BOX 658, BALTIMORE, MD 21203-0658
(703) 824-3200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101030459
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00203856
RAILROAD MEDICARE
—
Enumeration date
09/26/2006
Last updated
05/26/2011
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