Individual
GORDON J OSTRUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4745 OGLETOWN STANTON RD, SUITE 106, NEWARK, DE 19713-2067
(302) 454-9800
(302) 454-6446
Mailing address
4735 OGLETOWN STANTON RD, SUITE 1109, NEWARK, DE 19713-2072
(302) 454-9800
(302) 454-6446
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C10001861
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00083564000
AMERIHEALTH
—
01
—
304818
COVENTRY
DE
01
—
4288126
AETNA
—
01
—
E97888
BLUE CROSS BLUE SHIELD
DE
Enumeration date
04/26/2006
Last updated
04/02/2021
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