Individual
MR. MARC P. DIFAZIO
Active
Individual
MR. MARC P. DIFAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D0062946
MD
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
D0062946
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005139000
—
MD
05
—
010248221
—
VA
Enumeration date
05/18/2006
Last updated
09/18/2009
Update your record
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