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Individual

JOHN AUSTIN DEFRATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
575 S DUPONT HWY, NEW CASTLE, DE 19720-4606
(302) 328-3330
(302) 328-9336
Mailing address
95 ROSE ANN LN, WEST GROVE, PA 19390-8924
(302) 328-3330
(302) 328-9336

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
CL0005148
DE
2084N0400X
Neurology Physician
MD061195L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CL0005148
TAX ID NUMBER
DE
01
MD061195L
TAX ID NUMBER
PA
Enumeration date
07/15/2006
Last updated
07/29/2008
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