John Carmen Dercola in Marietta - Medical
John Carmen Dercola - NPI 1417952433
John Carmen Dercola is a Medical in Marietta, Georgia. John Carmen Dercola practices all healthcare services and medical treatments related to Medical. The NPI Number for John Carmen Dercola is 1417952433. The last update date is 2013-01-02.
John Carmen Dercola's current location address is 55 Whitcher St Ne, Marietta, Georgia. You can contact this provider via phone number 7704246893 and fax number 7705289926. The mailing address for John Carmen Dercola is 55 Whitcher St Ne, Marietta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Carmen Dercola |
|---|---|
| Address | 55 Whitcher St Ne, Marietta, Georgia |
| Phone Number | 7704246893 |
| Fax Number | 7705289926 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1417952433 |
|---|---|
| Provider Enumeration Date | 2005-06-16 |
| Last Updated Date | 2013-01-02 |
Provider Mailing Address Detail
| Address | 55 Whitcher St Ne |
|---|---|
| City | Marietta |
| State | Georgia (GA) |
| Post Code | 3006011550 |
| Phone Number | 7704246893 |
| Fax Number | 7705289926 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 2707 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100001072G | GA | -- | |
| 100001072F- | GA | -- | |
| 100001073B | GA | -- | |
| 100001073C | GA | -- | |
| 100001072H | GA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to John Carmen Dercola?
The John Carmen Dercola has been issued the NPI (National Provider Identifier) 1417952433 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of John Carmen Dercola?
The John Carmen Dercola is situated at 55 Whitcher St Ne, in the city of Marietta, state of GA, with the zip code 3006011550.
What is the John Carmen Dercola's area of specialization and corresponding taxonomy classification?
The John Carmen Dercola's specialty field is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their specialties.
On what date did the John Carmen Dercola receive the assignment of its 1417952433 from the Centers for Medicare & Medicaid Services?
The John Carmen Dercola was issued its 1417952433 by the Centers for Medicare & Medicaid Services on 2005-06-16.
As of what date was the information pertaining to John Carmen Dercola, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to John Carmen Dercola, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-01-02.