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DR. MICHAEL WILLIAM MARISCALCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4710 PUDDLEDOCK RD, SUITE 100, PRINCE GEORGE, VA 23875-1237
(804) 732-0095
(804) 732-0055
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101254090
VA
207X00000X
Orthopaedic Surgery Physician
57.012988
OH

Other

Enumeration date
02/21/2008
Last updated
09/12/2020
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