Individual
MS. CHARLA MARIE PHOENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
200 HYGEIA DR STE 1420, NEWARK, DE 19713-2049
(302) 623-3017
(302) 266-9962
Mailing address
620 STANTON CHRISTIANA RD, SUITE 302, NEWARK, DE 19713-2133
(302) 892-9400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0009749
MD
363AM0700X
Medical Physician Assistant
Primary
C5-0000735
DE
Other
Enumeration date
11/24/2010
Last updated
01/13/2025
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