Distefano, John F

Distefano, John F is an individual health care provider with primary practice located at 1970 Roanoke Blvd , Salem VA 24153-6404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Distefano, John F can be contacted via phone (540) 982-2463.

Contact Information

Primary practice address
1970 Roanoke Blvd Salem VA 24153-6404
Phone: (540) 982-2463
Fax: (540) 983-1022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 16510 West Virginia

Profile Details

NPI number 1134160229
LBN Legal business name Distefano, John F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated May 27th, 2011 - about 15 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 1134160229 NPPES
Kentucky MEDICAID 64071384
Kentucky Other P00002536
Kentucky MEDICAID 0073762000
Kentucky MEDICAID 2388250

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