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Individual

MICHAEL R DEPIETRO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4745 OGLETOWN STANTON RD, MAP 1, SUITE 220, NEWARK, DE 19713-2067
(302) 368-5515
(302) 366-1240
Mailing address
4745 OGLETOWN STANTON RD, MAP 1, SUITE 220, NEWARK, DE 19713-2067
(302) 368-5515
(302) 366-1240

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
C10005688
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000974301
DE
01
0295282000
AMERIHEALTH/KEYSTONE
01
1255450004
CIGNA
01
289288
MAMSI
01
4397310
AETNA/USHC
01
550894
INDEPENDENCE BCBS
01
58079
COVENTRY
01
60959401
CARE FIRST BCBS
MD
Enumeration date
05/10/2006
Last updated
07/09/2007
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