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Individual

DR. FIDEL DELEON MAKAPUGAY

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
491 W POPLAR AVE, COLLIERVILLE, TN 38017-2537
(901) 850-9900
(901) 853-2706
Mailing address
491 W POPLAR AVE, COLLIERVILLE, TN 38017-2537
(901) 850-9900
(901) 853-2706

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000021004
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3121215
BCBST-TN
TN
Enumeration date
05/11/2006
Last updated
07/08/2007
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