Healthcare Provider Details

I. General information

NPI: 1063166940
Provider Name (Legal Business Name): ABC STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22303 DUPONT BLVD
GEORGETOWN DE
19947-2153
US

IV. Provider business mailing address

18 CHUCKER XING
DOVER DE
19904-5572
US

V. Phone/Fax

Practice location:
  • Phone: 302-219-0376
  • Fax:
Mailing address:
  • Phone: 917-440-6074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGAD SINGH
Title or Position: OWNER
Credential: MD
Phone: 302-219-0376