Healthcare Provider Details

I. General information

NPI: 1487636148
Provider Name (Legal Business Name): DIANE ADEL ADAMS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANE ADEL SCHUCKER D.O.

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LOVERING AVE APT 104
WILMINGTON DE
19806-3274
US

IV. Provider business mailing address

P O XOX 824804
PHILADELPHIA PA
19182-4804
US

V. Phone/Fax

Practice location:
  • Phone: 148-892-6268
  • Fax:
Mailing address:
  • Phone: 302-691-3800
  • Fax: 302-778-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC2-0012979
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS008635L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: