Healthcare Provider Details

I. General information

NPI: 1649394594
Provider Name (Legal Business Name): ATLANTIC ORTHOPAEDICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35786 ATLANTIC AVE UNIT 2
MILLVILLE DE
19967-6955
US

IV. Provider business mailing address

88 ATLANTIC AVE
OCEAN VIEW DE
19970-9116
US

V. Phone/Fax

Practice location:
  • Phone: 410-641-1900
  • Fax:
Mailing address:
  • Phone: 302-541-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS BECK
Title or Position: PARTNER
Credential: DO
Phone: 410-641-1900