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DANIEL B DESIDERIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
93 CAMPUS AVE, LEWISTON, ME 04240-6030
(207) 777-8120
(207) 777-8984
Mailing address
PO BOX 95000 LBX 7650, PHILADELPHIA, PA 19195-0001

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21523
NH
207P00000X
Emergency Medicine Physician
Primary
MD25780
ME

Other

Enumeration date
04/24/2018
Last updated
11/08/2022
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