Provider Demographics
NPI:1861501975
Name:DIEPPA MULERO, DIOMEDES (MD)
Entity Type:Individual
Prefix:MR
First Name:DIOMEDES
Middle Name:
Last Name:DIEPPA MULERO
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:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-744-9759
Mailing Address - Fax:787-744-9759
Practice Address - Street 1:HOSPITAL HIMA-SAN PABLO
Practice Address - Street 2:AVE LMM URB MARIOLGA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-9759
Practice Address - Fax:787-744-9759
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10227207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
82894OtherTRIPLE S
7250018OtherHUMANA HEALTH INSURANCE
214101OtherPREFERRED HEALTH PLAN
993122OtherMEDICARE MUCHO MAS MMM
069989OtherLA CRUZ AZUL DE PUERTO RI
0082894Medicare ID - Type Unspecified
F47595Medicare UPIN