Healthcare Provider Details

I. General information

NPI: 1366676694
Provider Name (Legal Business Name): VIKRAM MAROCHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-0001
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD
NEWARK DE
19718-0001
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC7-0004260
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC7-0004260
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: