Individual
DR. CARL ANTHONY DIBLASIO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 867-4968
Mailing address
2256 EDGEWOOD DR, BULLHEAD CITY, AZ 86442-8834
(909) 223-3700
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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