Individual
MR. MICHAEL JOSEPH DISIENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
1230 MEDICAL CENTER DR, WILMINGTON, NC 28401-7332
(910) 799-5452
(910) 799-5479
Mailing address
444 N CULVERTON RD, WINNABOW, NC 28479-2103
(252) 526-1252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LCAS-687
NC
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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