Healthcare Provider Details
I. General information
NPI: 1124130778
Provider Name (Legal Business Name): DAVID MARC EPSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 BIDDLE AVE STE 206 SPRINGSIDE PLAZA, CONNOR BUILDING
NEWARK DE
19702-3969
US
IV. Provider business mailing address
300 BIDDLE AVE STE 206 SPRINGSIDE PLAZA, CONNOR BUILDING
NEWARK DE
19702-3969
US
V. Phone/Fax
- Phone: 302-392-2077
- Fax: 302-392-0020
- Phone: 302-392-2077
- Fax: 302-392-0020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | C1-0002711 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: