Healthcare Provider Details

I. General information

NPI: 1639177215
Provider Name (Legal Business Name): FRANCO MUSIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13135 LEE JACKSON MEMORIAL HWY 135
FAIRFAX VA
22033-1907
US

IV. Provider business mailing address

13135 LEE JACKSON MEMORIAL HWY SUITE 135
FAIRFAX VA
22033-1907
US

V. Phone/Fax

Practice location:
  • Phone: 703-961-0488
  • Fax: 703-961-0480
Mailing address:
  • Phone: 703-961-0488
  • Fax: 703-961-0480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0101057017
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: