Organization
FIRST STATE MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGH BONNER III M.D. (CEO/PRESIDENT)
(302) 479-0555
Entity
Organization
Contact information
Practice address
3521 SILVERSIDE RD, QUILLEN BUILDING SUITE 2D1, WILMINGTON, DE 19810-4900
(302) 479-0555
(302) 479-5006
Mailing address
3521 SILVERSIDE RD, QUILLEN BUILDING SUITE 2D1, WILMINGTON, DE 19810-4900
(302) 479-0555
(302) 479-5006
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C10004738
DE
Other
Enumeration date
11/07/2005
Last updated
08/22/2020
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