Individual
DR. DANIEL MACLEOD FISTERE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4400
(703) 698-4488
Mailing address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4400
(703) 698-4444
(703) 204-0116
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
287924-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
0101263565
VA
Other
Enumeration date
04/15/2011
Last updated
09/28/2020
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