Provider Demographics
NPI:1962614487
Name:DIGILIO, JOSEPH C
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:DIGILIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 EAST-WEST HWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4522
Mailing Address - Country:US
Mailing Address - Phone:301-652-3901
Mailing Address - Fax:
Practice Address - Street 1:4405 EAST-WEST HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4522
Practice Address - Country:US
Practice Address - Phone:301-652-3901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00550213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD182399Medicare PIN
MD182399P40Medicare PIN
T31030Medicare UPIN