Provider Demographics
NPI:1417115692
Name:DIMANCHE, PIERRE SHERLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:SHERLEY
Last Name:DIMANCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63-31 CALLE 52
Mailing Address - Street 2:URB. SIERRA BAYAMON
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4449
Mailing Address - Country:US
Mailing Address - Phone:787-667-8211
Mailing Address - Fax:
Practice Address - Street 1:63-31 CALLE 52
Practice Address - Street 2:URB. SIERRA BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4449
Practice Address - Country:US
Practice Address - Phone:787-667-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-24
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17063208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice