Healthcare Provider Details

I. General information

NPI: 1780065151
Provider Name (Legal Business Name): JOEL R TEMPLE MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 E LOOCKERMAN ST STE 303
DOVER DE
19901-8305
US

IV. Provider business mailing address

9 E LOOCKERMAN ST STE 303
DOVER DE
19901-8305
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-1343
  • Fax: 302-678-1344
Mailing address:
  • Phone: 302-678-1343
  • Fax: 302-678-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberC1-0000597
License Number StateDE

VIII. Authorized Official

Name: MS. SHAWN L EDWARDS
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-678-1343