Healthcare Provider Details

I. General information

NPI: 1306834585
Provider Name (Legal Business Name): LUIS M GARCIA JR. DPM FACFAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 LIMESTONE RD SUITE 208
WILMINGTON DE
19808-5400
US

IV. Provider business mailing address

1941 LIMESTONE RD SUITE 208
WILMINGTON DE
19808-5400
US

V. Phone/Fax

Practice location:
  • Phone: 302-994-5956
  • Fax: 302-994-9638
Mailing address:
  • Phone: 302-994-5956
  • Fax: 302-994-9638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE1-0000080
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: