Individual
DR. PAUL S MASSIMIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2921 TELESTAR CT, SUITE 140, FALLS CHURCH, VA 22042-1205
(703) 280-5858
(703) 280-2654
Mailing address
2921 TELESTAR CT, SUITE 140, FALLS CHURCH, VA 22042-1205
(703) 280-5858
(703) 280-2654
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101045274
VA
208600000X
Surgery Physician
0101045274
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
0101045274
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031197400
—
DC
05
—
350151500
—
MD
05
—
64073570
—
KY
05
—
7422113
—
VA
Enumeration date
03/17/2006
Last updated
12/06/2007
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