Healthcare Provider Details

I. General information

NPI: 1073590287
Provider Name (Legal Business Name): GARRETT HC COLMORGEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 03/07/2023
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST FL 6
DOVER DE
19901-3530
US

IV. Provider business mailing address

640 S STATE ST MAIL CODE 3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-6220
  • Fax: 302-734-8454
Mailing address:
  • Phone: 302-480-1688
  • Fax: 302-480-1688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC10002595
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberC10002595
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: