Healthcare Provider Details

I. General information

NPI: 1508916909
Provider Name (Legal Business Name): WILLIAM CHRISTOPHER EGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 11/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 OGLETOWN STANTON RD STE 3301
NEWARK DE
19713-7021
US

IV. Provider business mailing address

4735 OGLETOWN STANTON RD STE 3301
NEWARK DE
19713-7021
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-4370
  • Fax: 302-623-4375
Mailing address:
  • Phone:
  • Fax: 302-998-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0003076
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: