Individual
JACQUELINE W. DEPASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107
(215) 829-7817
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-7817
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD14920
RI
208M00000X
Hospitalist Physician
Primary
MD463333
PA
Other
Enumeration date
06/12/2012
Last updated
05/24/2018
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