Kent A Sallee, Md Llc | |
4031 Kennett Pike Wilmington DE 19807-2047 | |
(302) 757-3342 | |
Not Available |
Full Name | Kent A Sallee, Md Llc |
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Speciality | Family Medicine |
Location | 4031 Kennett Pike, Wilmington, Delaware |
Authorized Official Name and Position | Kent A Sallee (OWNER) |
Authorized Official Contact | 3027573342 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kent A Sallee, Md Llc Po Box 5110 Wilmington DE 19808-0110 Ph: (302) 633-5840 | Kent A Sallee, Md Llc 4031 Kennett Pike Wilmington DE 19807-2047 Ph: (302) 757-3342 |
NPI Number | 1730778937 |
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Provider Enumeration Date | 01/12/2021 |
Last Update Date | 01/12/2021 |
Medicare PECOS PAC ID | 7012323843 |
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Medicare Enrollment ID | O20210303000179 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730778937 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kent A Sallee |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295797264 PECOS PAC ID: 2466596168 Enrollment ID: I20101014001057 |
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