Healthcare Provider Details

I. General information

NPI: 1235282997
Provider Name (Legal Business Name): DELAWARE DERMATOLOGY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 S QUEEN ST SUITE 1
DOVER DE
19904-3529
US

IV. Provider business mailing address

737 S QUEEN ST SUITE 1
DOVER DE
19904-3529
US

V. Phone/Fax

Practice location:
  • Phone: 302-736-1800
  • Fax: 302-734-2769
Mailing address:
  • Phone: 302-736-1800
  • Fax: 302-734-2769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1994107811
License Number StateDE

VIII. Authorized Official

Name: DR. JOSEPH F ANDREWS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 302-736-1800