Provider Demographics
NPI:1588602080
Name:CIAMPOLI, JOSEPH A (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:CIAMPOLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 KIRKWOOD HIGHWAY SUITE 203
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808
Mailing Address - Country:US
Mailing Address - Phone:302-984-0257
Mailing Address - Fax:302-984-0258
Practice Address - Street 1:4512 KIRKWOOD HIGHWAY SUITE 203
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-984-0257
Practice Address - Fax:302-984-0258
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0000143213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2245524000OtherAMERIHEALTH GROUP #
DE0831652000OtherAMERIHEALTH PROVIDER #
DE200104566Medicaid
DE200104566Medicaid
DE2245524000OtherAMERIHEALTH GROUP #
DE2245524000OtherAMERIHEALTH GROUP #