Healthcare Provider Details

I. General information

NPI: 1932109097
Provider Name (Legal Business Name): RICHARD APPLEBY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 HIGHWAY ONE
LEWES DE
19958-1613
US

IV. Provider business mailing address

1010 HIGHWAY ONE
LEWES DE
19958-1613
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberC2-0005154
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: