Healthcare Provider Details

I. General information

NPI: 1306828330
Provider Name (Legal Business Name): DAVID ASHIR JAWAHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 S BRADFORD ST
DOVER DE
19904-4137
US

IV. Provider business mailing address

807 S BRADFORD ST
DOVER DE
19904-4137
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-7155
  • Fax: 302-674-7156
Mailing address:
  • Phone: 302-674-7155
  • Fax: 302-674-7156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberC10005844
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberC10005844
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: