Healthcare Provider Details

I. General information

NPI: 1578712592
Provider Name (Legal Business Name): JAVED AKHTAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32060 LONG NECK RD
MILLSBORO DE
19966-6228
US

IV. Provider business mailing address

424 SAVANNAH RD
LEWES DE
19958-1462
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5751
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0001005
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0005895
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: