Difazio, Marc P.

Difazio, Marc P. is an individual health care provider with primary practice located at 9715 Medical Center Dr Suite 414, Rockville MD 20850-3320. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Difazio, Marc P. can be contacted via phone (301) 309-2211.

Contact Information

Primary practice address
9715 Medical Center Dr Suite 414 Rockville MD 20850-3320
Phone: (301) 309-2211
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X D0062946 Maryland
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X D0062946 Maryland

Profile Details

NPI number 1972556462
LBN Legal business name Difazio, Marc P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Sep 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972556462 NPPES
Maryland MEDICAID 005139000
Maryland MEDICAID 010248221

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