Distasio, Anthony John

Distasio, Anthony John is an individual health care provider with primary practice located at 600 Gresham Dr Ste 204 , Norfolk VA 23507-1904. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Trauma. Allopathic & Osteopathic Physicians / Orthopaedic Trauma is his primary health care specialty. Distasio, Anthony John can be contacted via phone (757) 388-5680.

Contact Information

Primary practice address
600 Gresham Dr Ste 204 Norfolk VA 23507-1904
Phone: (757) 388-5680
Fax: (757) 388-5681
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 0101041449 Virginia
Allopathic & Osteopathic Physicians / Orthopaedic Trauma 207XX0801X 0101041449 Virginia

Profile Details

NPI number 1831195353
LBN Legal business name Distasio, Anthony John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Sep 16th, 2024 - about 2 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 1831195353 NPPES
Virginia MEDICAID 007306091

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