Organization
LIGHTHOUSE INTERNAL MEDICINE P.A.
Active
Organization
LIGHTHOUSE INTERNAL MEDICINE P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSIE WALTERS (OFFICE MANAGER)
(302) 422-5506
Entity
Organization
Contact information
Practice address
909 LAKEVIEW AVE, MILFORD, DE 19963-1731
(302) 422-5506
(302) 422-5507
Mailing address
909 LAKEVIEW AVE, MILFORD, DE 19963-1731
(302) 422-5506
(302) 422-5507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C100006175
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000036273
DELAWARE PHYSICIANS CARE
DE
05
—
1000036273
—
DE
01
—
DD5833
RAIL ROAD MEDICARE
DE
Enumeration date
05/25/2006
Last updated
06/27/2008
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