Individual
DR. IAN MICHAEL LONERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 PENNSYLVANIA AVE, WILMINGTON, DE 19806-4047
(302) 656-0214
(877) 284-8933
Mailing address
1600 PENNSYLVANIA AVE, WILMINGTON, DE 19806-4047
(302) 656-0214
(877) 284-8933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C20008811
DE
208200000X
Plastic Surgery Physician
5101017079
MI
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
C20008811
DE
208D00000X
General Practice Physician
C20008811
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136323YABT
MEDICARE ID
—
Enumeration date
03/24/2008
Last updated
04/22/2011
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