Provider Demographics
NPI:1700981594
Name:DEPREZ, DON PAUL (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:PAUL
Last Name:DEPREZ
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 1:291 LINCOLN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3643
Mailing Address - Country:US
Mailing Address - Phone:508-799-0010
Mailing Address - Fax:508-753-5501
Practice Address - Street 1:291 LINCOLN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3643
Practice Address - Country:US
Practice Address - Phone:508-799-0010
Practice Address - Fax:508-753-5501
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42919207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0142042Medicaid
N01892Medicare ID - Type Unspecified
A68016Medicare UPIN