Healthcare Provider Details

I. General information

NPI: 1679859193
Provider Name (Legal Business Name): WILLIAM M. DEPINA B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 07/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 INDUSTRIAL PARK RD
PLYMOUTH MA
02360-4881
US

IV. Provider business mailing address

145 FAUNCE CORNER RD STE K
N DARTMOUTH MA
02747-1263
US

V. Phone/Fax

Practice location:
  • Phone: 617-847-1950
  • Fax: 617-774-1490
Mailing address:
  • Phone: 774-206-1125
  • Fax: 774-628-9657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: