NICHOLAS DESTEFANO, MD

General Practice Physician · FORT GORDON, GA

Individual Active NPI 1154776755

Taxonomy & licensure

Specialty	Code	Primary	License	State
General Practice Physician	208D00000X	✓	30177	NE
Family Medicine Physician	207Q00000X		C1-0028577	DE

Medicare eligibility

Part B: Yes
DME: Yes
Home health: Yes
Power mobility: Yes
Hospice: Yes

At a glance

NPI: 1154776755
Entity type: Individual
Gender: Male
Sole proprietor: No
Enumerated: 2016-05-02
Last updated (NPPES): 2025-12-10

Location

Practice address: 300 E HOSPITAL RD, FORT GORDON, GA, 30905
Phone: 7063835299

Additional locations

32050 Long Neck Rd, Millsboro, DE, 199666228
424 Savannah Rd, Lewes, DE, 199581462
12100 Black Swan Dr Ste 104, Lewes, DE, 199584991
17388 N Village Main Blvd Unit 21, Lewes, DE, 199587240
21635 Biden Ave Unit 101, Georgetown, DE, 199474575
100 Silicato Pkwy Ste 201, Milford, DE, 199631273
28538 DuPont Blvd Unit 1, Millsboro, DE, 199664791
232 Mitchell St Unit 301, Millsboro, DE, 199669412
32550 Docs Pl Unit 2, Millville, DE, 199676975
23900 Milton Ellendale Hwy Ste 101, Milton, DE, 199682714
18947 John J Williams Hwy Unit 303, Rehoboth Beach, DE, 199714477
36450 Tidal Rd Unit 2, Selbyville, DE, 199754596
1008 Kings Hwy, Lewes, DE, 199581932
36223 Farm Ln Ste 140, Rehoboth Beach, DE, 199711329

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.