Healthcare Provider Details

I. General information

NPI: 1639155625
Provider Name (Legal Business Name): DELAWARE FAMILY CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SILVERSIDE RD
WILMINGTON DE
19810-3719
US

IV. Provider business mailing address

2700 SILVERSIDE RD
WILMINGTON DE
19810-3724
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-8421
  • Fax: 302-478-8422
Mailing address:
  • Phone: 302-478-8421
  • Fax: 302-478-8422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANE FREEBERY
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-478-8467