Organization
DELAWARE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA T PATRICKCOOKS (BILLING DEPARTMENT)
(302) 730-0554
Entity
Organization
Contact information
Practice address
810 NEW BURTON RD, SUITE 3, DOVER, DE 19904-5451
(302) 730-0554
(302) 730-1175
Mailing address
810 NEW BURTON RD, SUITE 3, DOVER, DE 19904-5451
(302) 730-0554
(302) 730-1175
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C10005294
DE
207R00000X
Internal Medicine Physician
C10005391
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001165602
—
DE
01
—
CK3544
PALMETTO GBA
DE
Enumeration date
06/23/2006
Last updated
10/27/2010
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