Provider Demographics
NPI:1396905519
Name:DRESSEL, DELVERNE ARTHUR JR (MD)
Entity type:Individual
Prefix:
First Name:DELVERNE
Middle Name:ARTHUR
Last Name:DRESSEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:604 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3829
Mailing Address - Country:US
Mailing Address - Phone:410-828-0244
Mailing Address - Fax:410-828-4042
Practice Address - Street 1:220 BOSLEY AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4311
Practice Address - Country:US
Practice Address - Phone:410-828-0244
Practice Address - Fax:410-828-4042
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00427822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD896431900Medicaid
MD896431900Medicaid