Individual
LISA MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 FOULK RD, SUITE 100B, WILMINGTON, DE 19803-2763
(302) 477-3300
(302) 477-3168
Mailing address
PO BOX 30170, WILMINGTON, DE 19805-7170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C1-0007767
DE
Other
Enumeration date
07/05/2006
Last updated
11/29/2011
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