Individual
KEVIN ANTHONY DIMAURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
901 ENTERPRISE PKWY STE 900, HAMPTON, VA 23666-6250
(757) 827-2480
(757) 827-2566
Mailing address
901 ENTERPRISE PKWY STE 900, HAMPTON, VA 23666-6250
(757) 827-2480
(757) 827-2566
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009350
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017645790001
—
VA
Enumeration date
01/02/2023
Last updated
02/01/2024
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