Healthcare Provider Details

I. General information

NPI: 1770583478
Provider Name (Legal Business Name): JAMES MONIHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N CLAYTON ST
WILMINGTON DE
19805
US

IV. Provider business mailing address

701 N CLAYTON ST STE 301 MSB
WILMINGTON DE
19805-3165
US

V. Phone/Fax

Practice location:
  • Phone: 302-575-8090
  • Fax:
Mailing address:
  • Phone: 302-575-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMD066861L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberC10004338
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: