Individual
DR. JEREMIAH J DEPUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8008 WESTPARK DR, KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER, MC LEAN, VA 22102-3109
(703) 287-6400
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101242180
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
STUDENT IN AN ORGANIZED H
DC
Enumeration date
01/10/2007
Last updated
09/17/2013
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