Healthcare Provider Details

I. General information

NPI: 1568580769
Provider Name (Legal Business Name): EMBER L. CREVAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD. CHRISTIANA CARE HOSPITAL - DEPT. OF PEDIATRICS
NEWARK DE
19718
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD. CHRISTIANA HOSPITAL, DEPT OF PEDIATRICS
NEWARK DE
19718
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-6500
  • Fax: 302-733-2711
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT189316
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0009151
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: