Individual
DR. MICHAEL PHILLIP DEPERRO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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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