Mario N Dalesandro, MS, ATC
Individual provider Active NPI Sports Medicine (Physical Medicine & Rehabilitation) Physician · Demorest, GA
NPI 1851945240 · NPPES record last updated Jul 24, 2019
Key facts
- NPI
- 1851945240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X
- License
- AT003429 (GA)
- Practice address
- 1021 Central Ave
Demorest, GA 30535-5252 - Phone
- (706) 778-3000
- NPI assigned
- Jul 24, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT003429 | GA | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | AT003429 | GA | Yes |
Addresses
Primary practice location
1021 Central Ave
Demorest, GA 30535-5252
Mailing address
PO Box 10
Demorest, GA 30535-0010
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | mdalesandro@piedmont.edu |
Other providers in Demorest, GA
- Covenant Emergency Physicians LLC
- Peyton Crawford
- CRHH-Atl, LLC
- Laura Ann Crone
- Haley Patton Dadd
- Linh My Dao
- Bailey M Daughtery
- Dana Davis
- Demorest Dialysis Facility, L.L.C.
- DFG LLC
All providers in Demorest, GA · Sports Medicine (Physical Medicine & Rehabilitation) Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.