Individual
MICHAEL D DETTORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 UNIVERSITY DR, M.S.HERSHEY MEDICAL CENTER, HERSHEY, PA 17033-2360
(717) 531-5337
(717) 531-0809
Mailing address
500 UNIVERSITY DR, M.S.HERSHEY MEDICAL CENTER, HERSHEY, PA 17033-2360
(717) 531-5337
(717) 531-0809
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
OS006989L
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
OS006989L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014126250006
—
PA
Enumeration date
10/12/2005
Last updated
12/21/2011
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