Healthcare Provider Details

I. General information

NPI: 1891793352
Provider Name (Legal Business Name): JOEL R TEMPLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 E LOOCKERMAN ST SUITE 303
DOVER DE
19901-8306
US

IV. Provider business mailing address

9 E LOOCKERMAN ST SUITE 303
DOVER DE
19901-8306
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:
Title or Position:
Credential:
Phone: