Individual
MARYANNE DEPUTRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0001053
DE
225100000X
Physical Therapist
PT009263L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146334VLZ
MEDICARE
PA
05
—
1629021464
—
DE
01
—
20029500000
AMERIHEALTH
DE
05
—
3556042
—
MD
01
—
836024
HIGHMARK
DE
01
—
836024
BCBS
PA
01
—
AC44-0021
CAREFIRST
DE
01
—
P00692858
RAILROAD MEDICARE
—
Enumeration date
05/19/2006
Last updated
07/23/2015
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