Healthcare Provider Details

I. General information

NPI: 1144252057
Provider Name (Legal Business Name): BETH B. DUPREE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 10/31/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 2ND STREET PIKE
SOUTHAMPTON PA
18966-3822
US

IV. Provider business mailing address

1648 HUNTINGDON PIKE MEDICAL STAFF OFFICE, 1ST FLR
MEADOWBROOK PA
19046
US

V. Phone/Fax

Practice location:
  • Phone: 215-633-3456
  • Fax: 215-396-3456
Mailing address:
  • Phone: 215-938-3450
  • Fax: 215-938-3829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD042133E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: