Individual
DR. CORMAC DERMITT DEPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 368-3103
Mailing address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 368-3103
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
246127
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2008
Last updated
07/06/2011
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