MEDICARE: OCEAN MEDICAL IMAGING OF DELAWARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center	C1-0004811	DE
2	261QR0206X	Mammography Clinic/Center	C1-0004811	DE
3	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164692240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN MEDICAL IMAGING OF DELAWARE, INC.

Provider Business Mailing Address
First Line	:	611 FEDERAL ST STE 4
Second Line	:
City	:	MILTON
State	:	DE
Zip	:	19968-1157
Country	:	US
Telephone Number	:	302-684-5151
Fax Number	:	302-684-1977

Provider Business Practice Location Address
First Line	:	611 FEDERAL ST STE 4
Second Line	:
City	:	MILTON
State	:	DE
Zip	:	19968-1157
Country	:	US
Telephone Number	:	302-684-5151
Fax Number	:	302-684-1977

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JONATHAN L PATTERSON
Credential	:	MD
Telephone Number	:	302-684-5151

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	08/29/2024

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Directions to “OCEAN MEDICAL IMAGING OF DELAWARE, INC. ” Practice Location

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