Divergent Direct Primary Care | |
1011 N Walnut St Milford DE 19963-1201 | |
(302) 734-2444 | |
(302) 493-5254 |
Full Name | Divergent Direct Primary Care |
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Speciality | Clinic/Center |
Location | 1011 N Walnut St, Milford, Delaware |
Authorized Official Name and Position | Tetsoma Tonwe (OWNER) |
Authorized Official Contact | 3027342444 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Divergent Direct Primary Care 1011 N Walnut St Milford DE 19963-1201 Ph: (302) 734-2444 | Divergent Direct Primary Care 1011 N Walnut St Milford DE 19963-1201 Ph: (302) 734-2444 |
NPI Number | 1871249193 |
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Provider Enumeration Date | 02/24/2022 |
Last Update Date | 02/24/2022 |
Certification Date | 02/11/2022 |
Medicare PECOS PAC ID | 3577958701 |
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Medicare Enrollment ID | O20220324001769 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871249193 | NPI | - | NPPES |
Provider Name | Tetsoma Tonwe |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629431267 PECOS PAC ID: 1052602968 Enrollment ID: I20200731001491 |
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