Individual
M LYNNE DUPONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
910 FOULK ROAD, SUITE 101, WILMINGTON, DE 19803-3157
(302) 655-3242
(302) 655-5392
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C10005471
DE
208000000X
Pediatrics Physician
MD067350L
PA
208D00000X
General Practice Physician
C10005471
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000958201
—
DE
05
—
0133345
—
NJ
05
—
101960506
—
PA
05
—
412689100
—
MD
Enumeration date
07/27/2006
Last updated
12/27/2011
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