| |
640 S State St Dover DE 19901-3530 | |
(302) 744-7039 | |
(302) 735-3848 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 640 S State St, Dover, Delaware |
Authorized Official Name and Position | Anthony F. Oliva (VICE PRESIDENT MEDICAL AFFAIRS) |
Authorized Official Contact | 3027447039 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
15 Goldenrod Ln Magnolia DE 19962-9365 Ph: (302) 335-1380 | 640 S State St Dover DE 19901-3530 Ph: (302) 744-7039 |
NPI Number | 1962495838 |
---|---|
Provider Enumeration Date | 08/25/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962495838 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | C20006782 (Delaware) | Primary |
Lee Dennis, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 960 Forest St, Dover, DE 19904 Phone: 302-735-1888 | |