MEDICARE: DR. MICHELE DELTIEURE M.D., MPH

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	25MA05038000	NJ
2	207R00000X	Internal Medicine Physician	ME106685	FL

General Provider Information

NPI Number	:	1821241779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE DELTIEURE M.D., MPH

Provider Business Mailing Address
First Line	:	1605 S US HIGHWAY 1
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33477-8436
Country	:	US
Telephone Number	:	561-242-3009
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 CENTRE PARK WEST DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6453
Country	:	US
Telephone Number	:	561-242-3009
Fax Number	:

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

Provider Enumeration Date	:	10/23/2008
Last Update Date	:	05/21/2010

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