Healthcare Provider Details

I. General information

NPI: 1033244496
Provider Name (Legal Business Name): ATLANTIC WOMENS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 POLK AVE
MILFORD DE
19963
US

IV. Provider business mailing address

306 POLK AVE
MILFORD DE
19963
US

V. Phone/Fax

Practice location:
  • Phone: 302-424-2200
  • Fax: 302-424-2202
Mailing address:
  • Phone: 302-424-2200
  • Fax: 302-424-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberCL0004906
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2002111176
License Number StateDE

VIII. Authorized Official

Name: MRS. CHRISTINA KEITH
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-424-2200