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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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