Individual
SVASTIJAYA DAVIRATANASILPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1198 S GOVERNORS AVE STE B100, DOVER, DE 19904-6930
(302) 424-3694
(302) 424-3697
Mailing address
4923 OGLETOWN STANTON RD, SUITE 200, NEWARK, DE 19713-2081
(302) 225-0451
(302) 225-0470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT184883
PA
207RN0300X
Nephrology Physician
Primary
C1-0008993
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203190
—
NJ
05
—
1720291404
—
DE
Enumeration date
05/08/2007
Last updated
06/17/2021
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