Healthcare Provider Details

I. General information

NPI: 1396283180
Provider Name (Legal Business Name): PHILIP W. HSU NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2017
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 S DUPONT HWY STE. #2
DOVER DE
19901-6405
US

IV. Provider business mailing address

4601 S DUPONT HWY STE. #2
DOVER DE
19901-6405
US

V. Phone/Fax

Practice location:
  • Phone: 302-698-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001006
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: