Individual
SANDRA MANCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30549 SUSSEX HWY, LAUREL, DE 19956-3891
(302) 990-3322
(302) 875-2560
Mailing address
30549 SUSSEX HWY, LAUREL, DE 19956-3891
(302) 990-3322
(302) 875-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C1-0008615
DE
207Q00000X
Family Medicine Physician
MD432023
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024555770
—
PA
Enumeration date
03/01/2007
Last updated
07/21/2022
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