Provider Demographics
NPI:1619917929
Name:FIELDING, DENNIS P (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:P
Last Name:FIELDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:17 ROUTE 23 N
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1419
Practice Address - Country:US
Practice Address - Phone:973-827-7800
Practice Address - Fax:973-209-7855
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ50608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0119041Medicaid
NJ0119041Medicaid
NJ536966ZB8UMedicare PIN