Healthcare Provider Details
I. General information
NPI: 1447058987
Provider Name (Legal Business Name): DELAWARE U.S. MOBILE CARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
325 S DUPONT RD
NEWPORT DE
19804-1637
US
IV. Provider business mailing address
325 S DUPONT RD
NEWPORT DE
19804-1637
US
V. Phone/Fax
- Phone: 347-298-4100
- Fax:
- Phone: 347-298-4100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
A
LADA
Title or Position: NP
Credential: NP
Phone: 347-298-4100