Provider Demographics
NPI:1114071198
Name:DEPEW, WESTLANE D (DO)
Entity Type:Individual
Prefix:DR
First Name:WESTLANE
Middle Name:D
Last Name:DEPEW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RIDGE PIKE
Mailing Address - Street 2:APT# 218B
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1929
Mailing Address - Country:US
Mailing Address - Phone:610-539-8500
Mailing Address - Fax:610-631-1252
Practice Address - Street 1:1033 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3905
Practice Address - Country:US
Practice Address - Phone:610-539-8500
Practice Address - Fax:610-631-1252
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010632L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine