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Organization

SMA PEDIATRICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MA CARIDAD ROSAL MD (PARTNER)
(302) 653-6174
Entity
Organization

Contact information

Practice address
38 DEAK DR, SMYRNA, DE 19977
(302) 653-6174
(302) 653-6029
Mailing address
38 DEAK DR, SMYRNA, DE 19977
(302) 653-6174
(302) 653-6029

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000185001
DE
01
1000038432
DPCI
01
2675733000
AMERIHEALTH HMO
01
467827
AETNA HMO 19
01
5304
AETNA PPO
01
8141834
ALLIANCE
Enumeration date
10/18/2006
Last updated
06/18/2008
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