Healthcare Provider Details

I. General information

NPI: 1649405713
Provider Name (Legal Business Name): FIRST STATE NEUROLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 SANDHILL DR SUITE 201A
MIDDLETOWN DE
19709-5805
US

IV. Provider business mailing address

4142 OGLETOWN STANTON RD SUITE 423
NEWARK DE
19713-4169
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-5460
  • Fax:
Mailing address:
  • Phone: 302-293-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2009602388
License Number StateDE

VIII. Authorized Official

Name: DR. RICHARD J. SCHUMANN
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: M.D.
Phone: 302-293-7524