Healthcare Provider Details

I. General information

NPI: 1285095265
Provider Name (Legal Business Name): MATTHEW P DEBO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E LOOCKERMAN ST STE 200
DOVER DE
19901-3779
US

IV. Provider business mailing address

663 ESTATES DR
CAMDEN WYOMING DE
19934-4606
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-4444
  • Fax:
Mailing address:
  • Phone: 302-480-1688
  • Fax: 302-480-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberC2-0023967
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: