Individual
DR. DMITRIY STASISHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 PARK AVE, FALLS CHURCH, VA 22046-4300
(571) 634-3636
Mailing address
200 PARK AVE, FALLS CHURCH, VA 22046-4300
(571) 634-3636
(703) 237-7959
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0102208614
VA
Other
Enumeration date
04/10/2019
Last updated
06/26/2024
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