# REGIONAL MEDICAL GROUP LLC

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

## Provider details

- **NPI number:** 1891048179
- **Authorized official:** SUSAN A CASSIDY (ADMINISTRATOR)
- **Authorized official phone:** (302) 993-7890

## Contact information

- **Practice address:** 4512 KIRKWOOD HWY, STE 202, WILMINGTON, DE 19808-5123
- **Practice address phone:** (302) 993-7890
- **Practice address fax:** (302) 993-7894
- **Mailing address:** 4512 KIRKWOOD HWY STE 202, WILMINGTON, DE 19808-5122
- **Mailing address phone:** (302) 999-0137
- **Mailing address fax:** (302) 999-1042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207UN0901X | Nuclear Cardiology Physician | — | NULL | — |
| 207UN0901X | Nuclear Cardiology Physician | — | — | — |

## Other

- **Enumeration date:** 10/24/2012
- **Last updated:** 03/15/2021