Healthcare Provider Details

I. General information

NPI: 1588602080
Provider Name (Legal Business Name): JOSEPH A CIAMPOLI D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4512 KIRKWOOD HIGHWAY SUITE 203
WILMINGTON DE
19808
US

IV. Provider business mailing address

4512 KIRKWOOD HIGHWAY SUITE 203
WILMINGTON DE
19808
US

V. Phone/Fax

Practice location:
  • Phone: 302-984-0257
  • Fax: 302-984-0258
Mailing address:
  • Phone: 302-984-0257
  • Fax: 302-984-0258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE1-0000143
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: