Delaware Medical Group, Llc | |
4512 Kirkwood Hwy Ste 205 Wilmington DE 19808-5123 | |
(302) 660-7302 | |
(302) 995-5426 |
Full Name | Delaware Medical Group, Llc |
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Speciality | Internal Medicine |
Location | 4512 Kirkwood Hwy Ste 205, Wilmington, Delaware |
Authorized Official Name and Position | Stuart Felzer (PRESIDENT) |
Authorized Official Contact | 3026331442 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Delaware Medical Group, Llc 4512 Kirkwood Hwy Ste 205 Wilmington DE 19808-5123 Ph: (302) 660-7302 | Delaware Medical Group, Llc 4512 Kirkwood Hwy Ste 205 Wilmington DE 19808-5123 Ph: (302) 660-7302 |
NPI Number | 1376581363 |
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Provider Enumeration Date | 06/03/2006 |
Last Update Date | 10/08/2024 |
Medicare PECOS PAC ID | 0345235578 |
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Medicare Enrollment ID | O20040417000257 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376581363 | NPI | - | NPPES |
0001195402 | Medicaid | DE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (Delaware) | Secondary |
Provider Name | Jill E Mackey |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578505863 PECOS PAC ID: 7911962881 Enrollment ID: I20041120000073 |
Provider Name | William R Nottingham |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1649213836 PECOS PAC ID: 0840285086 Enrollment ID: I20080215000501 |
Provider Name | Andrew P Myers |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477566446 PECOS PAC ID: 5395820245 Enrollment ID: I20080317000455 |
Provider Name | Stuart Felzer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508804402 PECOS PAC ID: 6406841642 Enrollment ID: I20110315001014 |
Provider Name | Kevin O Hara |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1538100672 PECOS PAC ID: 7416942651 Enrollment ID: I20110411000477 |
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