Healthcare Provider Details

I. General information

NPI: 1417189010
Provider Name (Legal Business Name): MAIMOONA INAYAT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2009
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PEOPLES PLZ STE 1235
NEWARK DE
19702-5701
US

IV. Provider business mailing address

364 E MAIN ST STE 203
MIDDLETOWN DE
19709-1482
US

V. Phone/Fax

Practice location:
  • Phone: 302-202-3848
  • Fax: 877-569-2560
Mailing address:
  • Phone: 413-344-3890
  • Fax: 877-569-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC1-0012844
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0012844
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0074487
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number240134
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: