Healthcare Provider Details

I. General information

NPI: 1144528308
Provider Name (Legal Business Name): THE PEARL CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28539 DUPONT BLVD
MILLSBORO DE
19966-4798
US

IV. Provider business mailing address

PO BOX 489
DAGSBORO DE
19939-0489
US

V. Phone/Fax

Practice location:
  • Phone: 302-648-2099
  • Fax: 302-648-2097
Mailing address:
  • Phone: 302-648-2099
  • Fax: 302-648-2097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC2-0009422
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberC2-0009422
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERIN HOWETT
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 302-648-2099