Individual
MAXIM ITKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 ROCKLAND RD, WILMINGTON, DE 19803-3607
(302) 651-4200
Mailing address
PO BOX 191, ROCKLAND, DE 19732-0191
(302) 651-4000
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
C1-0012739
DE
2085R0202X
Diagnostic Radiology Physician
MD420248
PA
2085R0204X
Vascular & Interventional Radiology Physician
MD420248
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008502500007
—
PA
05
—
100850250008
—
PA
Enumeration date
05/12/2006
Last updated
03/07/2023
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