Healthcare Provider Details

I. General information

NPI: 1487651741
Provider Name (Legal Business Name): RENE O. BADILLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BECKS WOODS DR SUITE 100
BEAR DE
19701-3851
US

IV. Provider business mailing address

121 BECKS WOODS DR SUITE 100
BEAR DE
19701-3851
US

V. Phone/Fax

Practice location:
  • Phone: 302-261-5600
  • Fax: 302-836-4302
Mailing address:
  • Phone: 302-261-5600
  • Fax: 302-836-4302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0006141
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: