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Organization

FIRST STATE ORTHOPAEDICS PA

Active
Parent organization
FIRST STATE ORTHOPAEDICS PA
Other names
Orthopaedic Associates of Southern Delaware
Organization subpart
Yes

Provider details

NPI number
Legal business name
FIRST STATE ORTHOPAEDICS PA
Authorized official
ARLEEN A AUKAMP (CREDENTIALING MANAGER)
(302) 451-6913
Entity
Organization

Contact information

Practice address
1539 SAVANNAH RD STE 203, BAYVIEW MEDICAL CENTER, LEWES, DE 19958-1674
(302) 644-3980
(302) 644-2804
Mailing address
211 EXECUTIVE DR STE 11, NEWARK, DE 19702-3358
(302) 731-2888
(302) 731-7049

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
208100000X
Physical Medicine & Rehabilitation Physician
213E00000X
Podiatrist
Primary
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000633502
DE
01
0848032000
AMERIHEALTH
01
1030265
AETNA US HEALTHCARE
01
204885
UNISON HEALTH PLAN
01
51-0343207
BLUE CROSS BLUE SHIELD OF DELAWARE
01
510370286
ONE NET PPO, MAMSI, OPTIMUM CHOICE, M.D. IPA
Enumeration date
09/05/2008
Last updated
11/08/2018
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