Individual
DR. VINCENT GUY DESIDERIO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3301 NEW MEXICO AVE NW, #248, WASHINGTON, DC 20016-3622
(202) 686-1286
(202) 686-6278
Mailing address
2420 44TH ST NW, WASHINGTON, DC 20007-1103
(202) 338-1895
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
12007
DC
Other
Enumeration date
12/15/2005
Last updated
02/14/2008
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