Healthcare Provider Details

I. General information

NPI: 1598884405
Provider Name (Legal Business Name): CMC DEPARTMENT OF MEDICINE GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7TH & CLAYTON STS SAINT FRANCIS MEDICAL CENTER
WILMINGTON DE
19805
US

IV. Provider business mailing address

3 COOPER PLZ SUITE 502
CAMDEN NJ
08103-1438
US

V. Phone/Fax

Practice location:
  • Phone: 302-421-4100
  • Fax:
Mailing address:
  • Phone: 856-342-2921
  • Fax: 856-968-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN E BEKES
Title or Position: CHIEF MEDICAL OFFICER, SVP
Credential:
Phone: 856-342-2921