Individual
FREDERICK DIMEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
655 S BAY RD STE 1F, DOVER, DE 19901-4694
(302) 730-4366
(302) 730-0231
Mailing address
640 S STATE ST, POB BLDG--3RD FLOOR, DOVER, DE 19901
(302) 480-1688
(302) 257-5777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C50000194
DE
363AS0400X
Surgical Physician Assistant
C50000194
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000015430
—
DE
01
—
168809ZA5H
MEDICARE NUMBER
DE
Enumeration date
07/06/2005
Last updated
01/07/2019
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