Organization
CHRISTIANA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANA KUTATELADZE (MD)
(302) 366-1868
Entity
Organization
Contact information
Practice address
4735 OGLETOWN STANTON RD, MAP-2, SUITE 2201, NEWARK, DE 19713-2072
(302) 366-1868
(302) 366-8572
Mailing address
4735 OGLETOWN STANTON RD, MAP-2, SUITE 2201, NEWARK, DE 19713-2072
(302) 366-1868
(302) 366-8572
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
C10008503
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C10008503
MEDICAL LICENSE
DE
Enumeration date
02/27/2007
Last updated
09/14/2007
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