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Individual

DR. MICHAEL PHILLIP DEPERRO III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1830 BETHEL RD STE 200, COLUMBUS, OH 43220-1809
(614) 429-4950
(614) 429-4948
Mailing address
1830 BETHEL RD STE 200, COLUMBUS, OH 43220-1809
(614) 429-4950
(614) 429-4948

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
112600
OH
208200000X
Plastic Surgery Physician
Primary
122373
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0165803
OH
05
1134573496
OH
01
811530392
TAX-ID
OH
Enumeration date
08/25/2008
Last updated
07/01/2025
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