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General NPI Number Information
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NPI Number | 1386632271
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Entity Type | Individual
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Provider Name | MARIA ANGELA DIZON MD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 701 N CLAYTON ST STE 301
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City | WILMINGTON
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State | DE
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Zip | 19805-3165
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Country | US
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Telephone | 302-578-8103
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Fax | 302-578-8144
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Provider Business Mailing Address
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Address Line | 701 N CLAYTON ST STE 301
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City | WILMINGTON
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State | DE
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Zip | 19805-3165
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Country | US
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Telephone | 302-578-8103
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Fax | 302-578-8144
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 20255
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD060183L
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License Number State | PA
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