Individual
CARLOS ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
701 N CLAYTON ST, MEDICAL OFFICE BLDG 401, WILMINGTON, DE 19805-3165
(302) 421-4800
(302) 421-4189
Mailing address
701 N CLAYTON ST, MEDICAL OFFICE BLDG 401, WILMINGTON, DE 19805-3165
(302) 421-4800
(302) 421-4189
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C5-0000352
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P71872
BLUE SHIELD DE
—
Enumeration date
08/13/2006
Last updated
11/13/2007
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