Healthcare Provider Details

I. General information

NPI: 1386993418
Provider Name (Legal Business Name): DELAWARE MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20468 COASTAL HWY
REHOBOTH BEACH DE
19971-8030
US

IV. Provider business mailing address

PO BOX 3626
WILMINGTON DE
19807-0626
US

V. Phone/Fax

Practice location:
  • Phone: 302-373-5366
  • Fax: 302-658-1014
Mailing address:
  • Phone: 302-373-5366
  • Fax: 302-658-1014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberC10004111
License Number StateDE

VIII. Authorized Official

Name: RALPH AURIGEMMA
Title or Position: MEMBER
Credential: MD
Phone: 302-373-5366