Healthcare Provider Details

I. General information

NPI: 1790760593
Provider Name (Legal Business Name): ARLENE J SMALLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARLENE SMALLS MD

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON ROAD SUITE 1900
NEWARK DE
19718
US

IV. Provider business mailing address

4755 OGLETOWN STANTON ROAD SUITE 1900
NEWARK DE
19718
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-6510
  • Fax: 302-733-3340
Mailing address:
  • Phone: 302-733-6510
  • Fax: 302-733-3340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC1-0004949
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD432576
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: