Individual
DR. VINSON MICHAEL DISANTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10725 BALD CYPRESS LN, KNOXVILLE, TN 37922-6760
(609) 760-8766
Mailing address
3 MAJESTIC WAY, MARLTON, NJ 08053-3774
(732) 542-2638
(732) 542-2620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A5627
CA
207Q00000X
Family Medicine Physician
Primary
DO0000001488
TN
207QA0505X
Adult Medicine Physician
25MB07769000
NJ
208D00000X
General Practice Physician
DO0000001488
TN
Other
Enumeration date
05/29/2007
Last updated
12/09/2020
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