Healthcare Provider Details

I. General information

NPI: 1184600942
Provider Name (Legal Business Name): INTERNAL MEDICINE OF DOVER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 SOUTH QUEEN ST
DOVER DE
19904
US

IV. Provider business mailing address

725 SOUTH QUEEN ST
DOVER DE
19904
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-4488
  • Fax: 302-678-4497
Mailing address:
  • Phone: 302-678-4488
  • Fax: 302-678-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. T NOBLE JARRELL III
Title or Position: PRESIDENT OF BUSINESS OWNER
Credential: MD
Phone: 302-678-4488