Healthcare Provider Details

I. General information

NPI: 1992455703
Provider Name (Legal Business Name): NATALIE MARIE SCANLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 OGLETOWN STANTON RD STE 2103
NEWARK DE
19713-8000
US

IV. Provider business mailing address

4735 OGLETOWN STANTON RD STE 2103
NEWARK DE
19713-8000
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-4410
  • Fax: 302-623-4415
Mailing address:
  • Phone: 302-623-4410
  • Fax: 302-623-4415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC1-0029344
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: