MEDICARE: DR. STANLEY T DEPMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD033216E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
10	080162557	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P2676083	OTHER		OXFORD
2	0058417000	OTHER	PA	KEYSTONE
3	081201	OTHER	PA	BLUE SHIELD
4	5829300	OTHER	PA	AETNA
5	0058417000	OTHER	PA	PERSONAL CHOICE
6	0163653904	OTHER	PA	AMERICHOICE
7	081201	OTHER	PA	IBC
8	1066839	OTHER	PA	KEYSTONE MERCY
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689667065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY T DEPMAN MD

Provider Business Mailing Address
First Line	:	3542 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-2623
Country	:	US
Telephone Number	:	215-333-6888
Fax Number	:	215-333-3945

Provider Business Practice Location Address
First Line	:	3542 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-2623
Country	:	US
Telephone Number	:	215-333-6888
Fax Number	:	215-333-3945

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	05/23/2014

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Directions to “ DR. STANLEY T DEPMAN MD” Practice Location

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