Organization
SELBYVILLE INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIO MANUEL DEPENA M.D. (PHYSICIAN/OWNER)
(302) 436-6394
Entity
Organization
Contact information
Practice address
18 MASON DIXON SHOPPING CTR, SELBYVILLE, DE 19975-9641
(302) 436-6394
(302) 436-6398
Mailing address
18 MASON DIXON SHOPPING CTR, SELBYVILLE, DE 19975-9641
(302) 436-6394
(302) 436-6398
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C10005626
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C10005626
DE STATE LICENSE
DE
Enumeration date
11/28/2007
Last updated
03/07/2023
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