Organization
HERITAGE MEDICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN VICTOR FENICE M.D. (OWNER)
(302) 998-3336
Entity
Organization
Contact information
Practice address
2601 ANNAND DR STE 4, HERITAGE PROFESSIONAL CENTER, WILMINGTON, DE 19808-3719
(302) 998-3334
Mailing address
2601 ANNAND DR STE 4, HERITAGE PROFESSIONAL CENTER, WILMINGTON, DE 19808-3719
(302) 998-3334
(302) 998-8985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C1-00007714
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033138169
PERSONAL NPI NUMBER
—
Enumeration date
06/27/2007
Last updated
03/16/2010
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