Individual
MICHAEL PAUL DAVID DIBELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
565 ABBOTT RD, BUFFALO, NY 14220-2039
(716) 828-2577
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A189249
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026056702
UNIVERA
NY
01
—
000525135003
BLUE CROSS BLUE SHIELD
NY
01
—
3990917
INDEPENDENT HEALTH
NY
Enumeration date
10/19/2005
Last updated
01/31/2018
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