Provider Demographics
NPI:1013142124
Name:JOHN GIUSTO, MD, PLLC
Entity Type:Organization
Organization Name:JOHN GIUSTO, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIUSTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-636-2226
Mailing Address - Street 1:9102 GREENBRIAR STA
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9747
Mailing Address - Country:US
Mailing Address - Phone:919-636-2226
Mailing Address - Fax:
Practice Address - Street 1:55 VILCOM CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1689
Practice Address - Country:US
Practice Address - Phone:919-929-7990
Practice Address - Fax:919-929-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99015322081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2279850EOtherMEDICARE