Provider Demographics
NPI:1962683797
Name:DIVILIO & DINAPOLI PA
Entity Type:Organization
Organization Name:DIVILIO & DINAPOLI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:DINAPOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-822-4281
Mailing Address - Street 1:404 MARVEL CT.
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4052
Mailing Address - Country:US
Mailing Address - Phone:410-822-4281
Mailing Address - Fax:
Practice Address - Street 1:404 MARVEL CT.
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4052
Practice Address - Country:US
Practice Address - Phone:410-822-4281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38990174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
297LMedicare PIN