Organization
SOUTHERN DELAWARE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTI POTTER RN,CNOR,MHCA (ADMINISTRATOR)
(302) 644-6992
Entity
Organization
Contact information
Practice address
18941 JOHN J WILLIAMS HWY, REHOBOTH BEACH, DE 19971-4404
(302) 644-6992
(302) 644-6995
Mailing address
18941 JOHN J WILLIAMS HWY, REHOBOTH BEACH, DE 19971-4404
(302) 644-6992
(302) 644-6995
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
FSSC-012
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000034296
—
DE
01
—
165A61
BLUE CROSS BLUE SHIELD
DE
Enumeration date
10/26/2005
Last updated
06/06/2008
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