Organization
MID-ATLANTIC SURGICAL PRACTICE
Active
Parent organization
MID-ATLANTIC SURGICAL PRACTICE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MID-ATLANTIC SURGICAL PRACTICE
Authorized official
JAMES JOSEPH TAYOUN JR. D.O. (PHYSICAN)
(302) 652-6050
Entity
Organization
Contact information
Practice address
1500 SHALLCROSS AVE, SUITE 1-A, WILMINGTON, DE 19806-3037
(302) 652-6050
(302) 652-6053
Mailing address
PO BOX 8157, WILMINGTON, DE 19803-8157
(302) 652-6050
(302) 652-6053
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000035769
—
DE
Enumeration date
08/04/2016
Last updated
08/17/2016
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