Individual
MBWIDIFFU A DIBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2600 GLASGOW AVE STE 104, NEWARK, DE 19702-5703
(302) 770-0030
(302) 273-0031
Mailing address
2600 GLASGOW AVE STE 104, NEWARK, DE 19702-5703
(302) 770-0030
(302) 273-0031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
LG-0000757
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200141998
—
DE
Enumeration date
10/22/2014
Last updated
05/08/2026
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