Healthcare Provider Details

I. General information

NPI: 1780619270
Provider Name (Legal Business Name): MAURICE A THEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3516 SILVERSIDE RD
WILMINGTON DE
19810-4932
US

IV. Provider business mailing address

PO BOX 3012
WILMINGTON DE
19804-0012
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-1213
  • Fax: 302-478-2274
Mailing address:
  • Phone: 302-224-5678
  • Fax: 302-224-2848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberC10002023
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberC10002023
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: