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Organization

DIVERGENT DIRECT PRIMARY CARE

Active
Other names
Divergent Primary Care
Organization subpart
No

Provider details

NPI number
Authorized official
TETSOMA TONWE (OWNER)
(302) 734-2444
Entity
Organization

Contact information

Practice address
1011 N WALNUT ST, MILFORD, DE 19963-1201
(302) 734-2444
(302) 493-5254
Mailing address
1011 N WALNUT ST, MILFORD, DE 19963-1201
(302) 734-2444
(302) 493-5254

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QP2300X
Primary Care Clinic/Center
Primary
332900000X
Non-Pharmacy Dispensing Site
347C00000X
Private Vehicle

Other

Enumeration date
02/24/2022
Last updated
02/24/2022
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