Provider Demographics
NPI:1659491314
Name:DIPASCO, PETER JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:DIPASCO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10050 KENNERLY RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2195
Mailing Address - Country:US
Mailing Address - Phone:314-525-4440
Mailing Address - Fax:314-525-4531
Practice Address - Street 1:10050 KENNERLY RD STE 2500
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2195
Practice Address - Country:US
Practice Address - Phone:314-525-4440
Practice Address - Fax:314-525-4531
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-347182086X0206X
FLME 1113872086X0206X
MO20200363032086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology