Healthcare Provider Details

I. General information

NPI: 1205938479
Provider Name (Legal Business Name): PIKE CREEK ASSOCIATES IN WOMENCARE P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 NEW LINDEN HILL RD BROWNSTONE PLAZA SUITE 202
WILMINGTON DE
19808-2953
US

IV. Provider business mailing address

4600 NEW LINDEN HILL RD BROWNSTONE PLAZA SUITE 202
WILMINGTON DE
19808-2953
US

V. Phone/Fax

Practice location:
  • Phone: 302-995-7073
  • Fax: 302-995-9103
Mailing address:
  • Phone: 302-995-7073
  • Fax: 302-995-9103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC10002529
License Number StateDE

VIII. Authorized Official

Name: DR. CHRISTINE W MAYNARD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 302-995-7073