Healthcare Provider Details

I. General information

NPI: 1124212865
Provider Name (Legal Business Name): TYREE M.S. WINTERS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB09747200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34009546
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: