| |
1 Centurian Dr, Suite 105, Newark, DE 19713-2137 | |
(302) 999-0933 | |
(302) 999-8633 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 1 Centurian Dr, Newark, Delaware |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164592168 | NPI | - | NPPES |
000740771 | Other | HIGHMARK BS | |
0531163000 | Other | AMERIHEALTH | |
771103400 | Medicaid | MD | |
0001043202 | Medicaid | DE | |
27643 | Other | DE | COVENTRY |
343RFA | Other | CAREFIRST BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 1999208770 (Delaware) | Secondary |
207Q00000X | Family Medicine | 1999208770 (Delaware) | Primary |
Provider Name | Patricia Juma Munda |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053371385 PECOS PAC ID: 7810062684 Enrollment ID: I20080814000122 |
Provider Name | Robert D Winter |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932279007 PECOS PAC ID: 4183792864 Enrollment ID: I20081010000088 |
Provider Name | Arlen D Stone |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396703765 PECOS PAC ID: 1557439239 Enrollment ID: I20081010000120 |
Mailing Address | Practice Location Address |
---|---|
1 Centurian Dr, Suite 105, Newark, DE 19713-2137 Ph: (302) 999-0933 | 1 Centurian Dr, Suite 105, Newark, DE 19713-2137 Ph: (302) 999-0933 |