Organization
FIRST STATE FAMILY PRACTICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KEHAGIAS MD (PHYSICIAN/OWNER)
(302) 378-5494
Entity
Organization
Contact information
Practice address
222 CARTER DR, SUITE 101, MIDDLETOWN, DE 19709-5854
(302) 378-5494
(302) 378-1760
Mailing address
222 CARTER DR, SUITE 101, MIDDLETOWN, DE 19709-5854
(302) 378-5494
(302) 378-1760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C10006722
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080195041
RAILROAD MEDICARE
DE
01
—
1000021662
DPCI
DE
05
—
1000021662
—
DE
01
—
1463747
AMERIHEALTH PPO
DE
01
—
2148253000
AMERIHEALTH HMO
DE
01
—
3157375
AETNA
DE
Enumeration date
10/25/2006
Last updated
03/19/2012
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