Individual
FRANKLIN A. DEPETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-3821
(508) 334-5586
Mailing address
951 IRONWOOD CT, MARCO ISLAND, FL 34145-4418
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
223067
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104041
—
MA
01
—
468439
TUFTS HEALTH PLAN
MA
01
—
J28816
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/05/2006
Last updated
07/08/2007
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