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Individual
DR. MARLENE GABRIEL DESAMITO
Active
Individual
DR. MARLENE GABRIEL DESAMITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0053700
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1203744
UHC/AMERICHOICE PROV. NO
MD
05
—
1356020 00
—
MD
01
—
7221153
AETNA PROV. NO.
MD
01
—
94909
AMERIGROUP PROV. NO.
MD
Enumeration date
10/24/2006
Last updated
06/20/2009
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