Healthcare Provider Details

I. General information

NPI: 1265515464
Provider Name (Legal Business Name): IRENE C. VIOLA, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 SAVANNAH RD SUITE 8
LEWES DE
19958-1656
US

IV. Provider business mailing address

1606 SAVANNAH RD SUITE 8
LEWES DE
19958-1656
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-1450
  • Fax: 302-644-0650
Mailing address:
  • Phone: 302-644-1450
  • Fax: 302-644-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0006063
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberC1-0006063
License Number StateDE

VIII. Authorized Official

Name: IRENE C VIOLA
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 302-644-1450