# SOUTHERN DELAWARE MEDICAL GROUP, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386662054
- **Authorized official:** OLGA SAMARY GONZALEZ (PRACTICE MANAGER)
- **Authorized official phone:** (302) 725-2040

## Contact information

- **Practice address:** 100 SILICATO PKWY STE 301, MILFORD, DE 19963-1272
- **Practice address phone:** (302) 725-2040
- **Practice address fax:** (855) 403-0778
- **Mailing address:** PO BOX 337, MILFORD, DE 19963-0337
- **Mailing address phone:** (302) 725-2040
- **Mailing address fax:** (855) 403-0778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | C20006015 | DE | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 09/16/2021