MEDICARE: DR. RENELL DUPREE M.D.

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	MD460033	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821409764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENELL DUPREE M.D.

Provider Business Mailing Address
First Line	:	8250 OLD YORK RD FL 2
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1514
Country	:	US
Telephone Number	:	215-886-0440
Fax Number	:	215-886-0447

Provider Business Practice Location Address
First Line	:	8250 OLD YORK RD FL 2
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-1514
Country	:	US
Telephone Number	:	215-886-0440
Fax Number	:	215-886-0447

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

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	07/21/2022

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Directions to “ DR. RENELL DUPREE M.D.” Practice Location

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