Healthcare Provider Details

I. General information

NPI: 1770017121
Provider Name (Legal Business Name): SEAN JAMES DIKDAN M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HYGEIA DR STE 1360
NEWARK DE
19713-2049
US

IV. Provider business mailing address

200 HYGEIA DR STE 1360
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-1929
  • Fax: 302-368-7943
Mailing address:
  • Phone: 302-623-1929
  • Fax: 302-368-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0028078
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0104523
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0104523
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC1-0028078
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: