Individual
WILLY WIDJAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
Mailing address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(410) 368-8858
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C1-0012545
DE
207R00000X
Internal Medicine Physician
P31998
MD
Other
Enumeration date
06/29/2015
Last updated
01/03/2022
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