Individual
DR. AMUDHA BOOPATHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
30265 COMMERCE DR, MILLSBORO, DE 19966-3593
(302) 629-5050
(302) 629-5053
Mailing address
PO BOX 191, ROCKLAND, DE 19732-0191
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C1-0011009
DE
208D00000X
General Practice Physician
Primary
C10011009
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103448773
—
PA
Enumeration date
07/19/2011
Last updated
02/21/2020
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