DR. MICHAEL WILLIAM MARISCALCO (NPI# 1912176140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912176140 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL WILLIAM MARISCALCO |
| Credential | M.D. |
| Practice Address |
4710 Puddledock Rd Suite 100 Prince George VA 23875-1237 |
| Mailing Address |
1115 Boulders Pkwy Suite 200 North Chesterfield VA 23225-4067 |
| Practice Telephone | 8047320095 |
| Practice Fax Number | 8047320055 |
| Mailing Telephone | 8045605595 |
| Mailing Fax Number | 8045609029 |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2020-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 0101254090 | VA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 57.012988 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
4710 PUDDLEDOCK RD SUITE 100 |
| City | PRINCE GEORGE |
| State | VA |
| Zip Code | 23875-1237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073580221 | Baljit S Sidhu | Neuromusculoskeletal Medicine & OMM | 4710 Puddledock Rd, Suite 100, Prince George, VA 23875-1237 | 2006-03-07 |
| 1033770862 | William Samuel Grizzard IIi | Dentist | 4710 Puddledock Rd, Prince George, VA 23875-1269 | 2019-06-24 |
| 1568901999 | John Claude Dodd | Physical Therapist | 4710 Puddledock Rd, Prince George, VA 23875-1269 | 2017-02-17 |
| 1396299236 | Gregory Banks | Physical Therapist | 4710 Puddledock Rd, Ste 100, Prince George, VA 23875-1269 | 2016-08-09 |
| 1811340748 | Virginia Stevens | Physical Therapist | 4710 Puddledock Rd, Suite 100, Prince George, VA 23875-1269 | 2016-07-15 |
| 1275919565 | Lauren Jones | Physical Therapist | 4710 Puddledock Rd, Suite 100, Prince George, VA 23875-1269 | 2015-08-10 |
| 1962895623 | Mark B Mckinley | Physical Therapist | 4710 Puddledock Rd, Ste 100, Prince George, VA 23875-1269 | 2015-03-05 |
| 1568860674 | Amanda W Sayers | Physical Therapist | 4710 Puddledock Rd, Suite 100, Prince George, VA 23875-1269 | 2014-12-06 |
| 1780085969 | Amanda L Garnett | Physical Therapist | 4710 Puddledock Rd, Prince George, VA 23875-1269 | 2014-09-08 |
| 1033548441 | Orthovirginia, Inc. | Physician Assistant | 4710 Puddledock Rd, Suite 100, Prince George, VA 23875-1237 | 2013-11-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083228902 | Lr Counseling Services, LLC | Community/Behavioral Health | 5000 Owens Way, Apt. 622, Prince George, VA 23875 | 2020-09-08 |
| 1053815423 | Yolanda Larrette Hoag | Nurse Practitioner | 4600 Puddledock Rd, Prince George, VA 23875 | 2018-03-21 |
| 1932534864 | Foundation for Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4301 Montreal Ave., Prince George, VA 23875 | 2013-09-11 |
| 1073889697 | Jemina M Liverman | Nurse Practitioner | 4260 Crossing Blvd, Prince George, VA 23875 | 2012-03-28 |
| 1245412717 | Prince George County Public Schools | Local Education Agency (LEA) | 6410 Courts Drive, Prince George, VA 23875 | 2007-11-27 |
| 1952330193 | Commonwealth of Virginia State Board of Health | Public Health or Welfare | 6459 Administration Dr., Prince George, VA 23875 | 2006-07-01 |
| 1598173155 | Divine Spine Chiropractic | Chiropractor | 4205 Crossings Blvd, Prince George, VA 23875 | 2014-07-28 |
| 1669632782 | Ashif K Jethava | Internal Medicine | 4720 Puddledock Rd, Suite 100b, Prince George, VA 23875 | 2008-06-12 |
| 1043873664 | Branbur Dialysis LLC | Clinic/Center | 4650 Puddledock Rd, Prince George, VA 23875-1235 | 2019-04-18 |
| 1033754874 | Jessica M Larche | Nurse Practitioner | 4600 Puddledock Rd, Prince George, VA 23875-1235 | 2019-11-15 |
| Find all providers in zip 23875 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720695059 | Central Virginia Orthopaedics & Sports Medicine | Orthopaedic Surgery | 450 Garrisonville Rd Ste 101, Stafford, VA 22554-1615 | 2020-09-30 |
| 1992318067 | Loudoun Medical Group . P.c | Orthopaedic Surgery | 224d Cornwall St Nw Ste 403, Leesburg, VA 20176-2704 | 2020-08-28 |
| 1093324378 | Loudoun Medical Group . P.c | Orthopaedic Surgery | 19450 Deefield Avenue, Suite 200, Leesburg, VA 20176-2017 | 2020-07-23 |
| 1285242867 | Loudoun Medical Group . P.c | Orthopaedic Surgery | 24430 Stone Springs Blvd Unit 100, Sterling, VA 20166-2269 | 2020-07-20 |
| 1750999892 | Loudoun Medical Group . P.c | Orthopaedic Surgery | 224d Cornwall St Nw Ste 230, Leesburg, VA 20176-2704 | 2020-07-15 |
| 1154946093 | Orthovirgina, Inc. | Orthopaedic Surgery | 1760 Old Meadow Rd Ste 500, Mc Lean, VA 22102-4306 | 2020-06-16 |
| 1144849100 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 1715 N George Mason Dr Ste 102, Arlington, VA 22205-3637 | 2020-04-10 |
| 1134748221 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 11230 Waples Mill Rd Ste 114c, Fairfax, VA 22030-5026 | 2020-04-09 |
| 1649810805 | Anderson Clinic Inc | Orthopaedic Surgery | 3299 Woodburn Rd Ste 480, Annandale, VA 22003-7333 | 2020-01-15 |
| 1871136622 | Orthovirginia Inc. | Orthopaedic Surgery | 24600 Millstream Dr Ste 380, Aldie, VA 20105-5686 | 2019-10-24 |
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| City | PRINCE GEORGE |
| Zip Code | 23875 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.