Seaside Primary Care Llc | |
750 Kings Hwy Ste 103 Lewes DE 19958-1772 | |
(302) 542-3171 | |
Not Available |
Full Name | Seaside Primary Care Llc |
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Speciality | Family Medicine |
Location | 750 Kings Hwy Ste 103, Lewes, Delaware |
Authorized Official Name and Position | Gregory A Bahtiarian (PHYSICIAN/OWNER) |
Authorized Official Contact | 3025423171 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Seaside Primary Care Llc 750 Kings Hwy Ste 103 Lewes DE 19958-1772 Ph: (302) 542-3171 | Seaside Primary Care Llc 750 Kings Hwy Ste 103 Lewes DE 19958-1772 Ph: (302) 542-3171 |
NPI Number | 1346987443 |
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Provider Enumeration Date | 05/19/2022 |
Last Update Date | 05/19/2022 |
Medicare PECOS PAC ID | 0749662674 |
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Medicare Enrollment ID | O20220809001026 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346987443 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Gregory Bahtiarian |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295738250 PECOS PAC ID: 2264334986 Enrollment ID: I20040123000223 |
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