Provider Demographics
NPI:1952395451
Name:PARE, JOHN L (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:PARE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1515 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-313-2298
Mailing Address - Fax:302-645-3691
Practice Address - Street 1:32550 DOCS PL UNIT 2
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6975
Practice Address - Country:US
Practice Address - Phone:302-539-4302
Practice Address - Fax:302-539-4305
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102049956207Q00000X
DEC2-0013654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA05624223Medicaid
080175703OtherRR MEDICARE
G02038Medicare UPIN
080175703OtherRR MEDICARE