Healthcare Provider Details

I. General information

NPI: 1356487854
Provider Name (Legal Business Name): DELAWARE CENTER FOR MATERNAL FETAL MEDICINE OF CHRISTIANA CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CENTURIAN DR STE 312
NEWARK DE
19713-2127
US

IV. Provider business mailing address

1 CENTURIAN DR STE 312
NEWARK DE
19713-2127
US

V. Phone/Fax

Practice location:
  • Phone: 302-319-5680
  • Fax: 302-319-5681
Mailing address:
  • Phone: 302-319-5680
  • Fax: 302-319-5681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH A. WILLIAMS
Title or Position: CEO
Credential:
Phone: 302-319-5680