Healthcare Provider Details

I. General information

NPI: 1548438831
Provider Name (Legal Business Name): DOUGLAS SZELL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

PO BOX 826515
PHILADELPHIA PA
19182-6515
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4700
  • Fax: 302-744-6407
Mailing address:
  • Phone: 888-733-7271
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL6-0A00547
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: