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1740591304

NPI Code Detail

MEDICARE: DR. MARIE DIDARIO D.O.

MEDICARE: DR. MARIE DIDARIO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	28-321	WI
2	2084P0800X	Psychiatry Physician	2019014130	MO
3	2084P0800X	Psychiatry Physician	4960	TN
4	2084P0800X	Psychiatry Physician	EMC0004322	MI
5	2084P0800X	Psychiatry Physician	DO187103	OR
6	2084P0800X	Psychiatry Physician	25MB09730100	NJ
7	2084P0800X	Psychiatry Physician	63970	MN
8	2084P0800X	Psychiatry Physician	R3660	TX
9	2084P0800X	Psychiatry Physician	OP60872131	WA
10	2084P0800X	Psychiatry Physician	26277	MS
11	2084P0800X	Psychiatry Physician	0102207666	VA

General Provider Information

NPI Number	:	1740591304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE DIDARIO D.O.

Provider Business Mailing Address
First Line	:	1021 W OAKLAND AVE STE 310
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2192
Country	:	US
Telephone Number	:	423-302-6565
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 GASTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2088
Country	:	US
Telephone Number	:	888-285-2269
Fax Number	:	512-838-4264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	09/03/2025

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Directions to “ DR. MARIE DIDARIO D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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