Healthcare Provider Details

I. General information

NPI: 1730129594
Provider Name (Legal Business Name): ATLANTIC PHYSICIAN SERVICES OF MARYLAND, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N CLAYTON ST.
WILMINGTON DE
19805-0000
US

IV. Provider business mailing address

PO BOX 634994
CINCINNATI OH
45263-5023
US

V. Phone/Fax

Practice location:
  • Phone: 856-686-4316
  • Fax:
Mailing address:
  • Phone: 856-686-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES J FLOWERS
Title or Position: DIRECTOR
Credential: D.O.
Phone: 856-848-3817