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NPI Code Detail

MEDICARE: DEBORAH ANN DIPERSIO MD

MEDICARE: DEBORAH ANN DIPERSIO 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
12085R0202XDiagnostic Radiology Physician9400472NC

Other Identifiers

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

General Provider Information

NPI Number : 1972504272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH ANN DIPERSIO MD
Provider Business Mailing Address
First Line : 1705 GARDNER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-8873
Country : US
Telephone Number : 910-343-5300
Fax Number :
Provider Business Practice Location Address
First Line : 1705 GARDNER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-8873
Country : US
Telephone Number : 910-343-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 04/27/2022

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Directions to “ DEBORAH ANN DIPERSIO MD” Practice Location

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