Healthcare Provider Details

I. General information

NPI: 1467502773
Provider Name (Legal Business Name): IMRAN TRIMZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 12/08/2024
Certification Date: 12/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5163 W WOODMILL DR STE 13
WILMINGTON DE
19808-4067
US

IV. Provider business mailing address

5163 W WOODMILL DR STE 13
WILMINGTON DE
19808-4067
US

V. Phone/Fax

Practice location:
  • Phone: 302-660-7200
  • Fax: 302-543-5644
Mailing address:
  • Phone: 302-660-7200
  • Fax: 302-543-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC10006895
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberC10006895
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC10006895
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: