Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | C10008229 | DE |
N | 208D00000X | General Practice Physician | C10008229 | DE |
NPI | 1033254396 |
---|---|
Provider Name | Dr. Matthew D. Di Guglielmo |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 12/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0139173 | (05) | NJ |
4134532 | (05) | MD |