Healthcare Provider Details

I. General information

NPI: 1801905849
Provider Name (Legal Business Name): INFECTIOUS DISEASE CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 STANTON CHRISTIANA RD SUITE 201
NEWARK DE
19713-2146
US

IV. Provider business mailing address

537 STANTON CHRISTIANA RD SUITE 201
NEWARK DE
19713-2146
US

V. Phone/Fax

Practice location:
  • Phone: 302-994-9692
  • Fax: 302-994-9803
Mailing address:
  • Phone: 302-994-9692
  • Fax: 302-994-9803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MARSHALL T WILLIAMS
Title or Position: PRESIDENT
Credential: M.D., PHD
Phone: 302-994-9692