Healthcare Provider Details

I. General information

NPI: 1164692240
Provider Name (Legal Business Name): OCEAN MEDICAL IMAGING OF DELAWARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 FEDERAL ST STE 4
MILTON DE
19968-1157
US

IV. Provider business mailing address

611 FEDERAL ST STE 4
MILTON DE
19968-1157
US

V. Phone/Fax

Practice location:
  • Phone: 302-684-5151
  • Fax: 302-684-1977
Mailing address:
  • Phone: 302-684-5151
  • Fax: 302-684-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberC1-0004811
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License NumberC1-0004811
License Number StateDE

VIII. Authorized Official

Name: DR. JONATHAN L PATTERSON
Title or Position: OWNER
Credential: MD
Phone: 302-684-5151