Individual
HY J DEPAMPHILIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
(717) 531-7269
Mailing address
1800 E PARK AVE, STATE COLLEGE, PA 16803-6709
(814) 231-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD029689E
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD029689E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0913797
—
PA
01
—
238424
MAMSI
PA
01
—
2683
MARYLAND BLUE SHIELD
MD
01
—
521518160
YORK HEALTH
PA
01
—
8120073
CIGNA
PA
01
—
991630
KEYSTONE HEALTH
PA
Enumeration date
05/23/2005
Last updated
07/06/2011
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