| Delaware | |
|
1000 N West St Ste 1200 Wilmington DE 19801-1058 | |
| (657) 400-5180 | |
| Not Available |
| Full Name | Delaware |
|---|---|
| Speciality | General Practice |
| Location | 1000 N West St Ste 1200, Wilmington, Delaware |
| Authorized Official Name and Position | Christopher Dennis (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 6574005180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delaware 7755 Center Ave Ste 630 Huntington Beach CA 92647-9152 Ph: () - | Delaware 1000 N West St Ste 1200 Wilmington DE 19801-1058 Ph: (657) 400-5180 |
| NPI Number | 1366167835 |
|---|---|
| Provider Enumeration Date | 10/07/2022 |
| Last Update Date | 01/30/2024 |
| Medicare PECOS PAC ID | 8527453851 |
|---|---|
| Medicare Enrollment ID | O20230110000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366167835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Cheryl Ann Denick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548294739 PECOS PAC ID: 0042376246 Enrollment ID: I20230110000026 |
| Provider Name | Edward Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952369548 PECOS PAC ID: 8426009119 Enrollment ID: I20230511001366 |
| Provider Name | Darko Bijelic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851798177 PECOS PAC ID: 8729303334 Enrollment ID: I20230714001847 |
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