Organization
CENTER FOR INTERVENTIONAL PAIN SPINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIE PAULUS (PRACTICE MANAGER)
(844) 365-7246
Entity
Organization
Contact information
Practice address
405 SILVERSIDE RD STE 104, WILMINGTON, DE 19809-1768
(844) 365-2202
(844) 558-1878
Mailing address
223 WILMINGTON W CHESTER PIKE STE 214, CHADDS FORD, PA 19317-9007
(844) 365-7246
(844) 558-1878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250610288
—
DE
Enumeration date
11/01/2022
Last updated
11/01/2022
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