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Individual

STEPHEN ERNEST DEPASQUALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
102 CENTRAL AVENUE, CHATTANOOGA, TN 37403-1503
(423) 266-3636
(423) 266-3633
Mailing address
102 CENTRAL AVE, CHATTANOOGA, TN 37403-2136
(423) 266-3636
(423) 266-3633

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
35113
TN
207VX0201X
Gynecologic Oncology Physician
50154
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000932071C
GA
Enumeration date
05/16/2006
Last updated
06/27/2012
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