Provider Demographics
NPI:1831146562
Name:CAMPO, DARRIN GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:GEORGE
Last Name:CAMPO
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 1:102 SLEEPY HOLLOW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8894
Mailing Address - Country:US
Mailing Address - Phone:302-376-8899
Mailing Address - Fax:302-376-8890
Practice Address - Street 1:102 SLEEPY HOLLOW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8894
Practice Address - Country:US
Practice Address - Phone:302-376-8899
Practice Address - Fax:302-376-8890
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004487207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG01909Medicare UPIN
DEG02201A01Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
DEG02201Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER