Healthcare Provider Details

I. General information

NPI: 1558225755
Provider Name (Legal Business Name): DELAWARE PHYSICIANS PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CONCORD AVE STE 101
WILMINGTON DE
19802-3366
US

IV. Provider business mailing address

5 PARK CENTER CT STE 200
OWINGS MILLS MD
21117-4202
US

V. Phone/Fax

Practice location:
  • Phone: 410-358-2518
  • Fax: 410-358-0093
Mailing address:
  • Phone: 410-358-2518
  • Fax: 410-358-0093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDRE SPIAK
Title or Position: CFO
Credential: CPA
Phone: 443-341-2098