Healthcare Provider Details

I. General information

NPI: 1255457024
Provider Name (Legal Business Name): DELMARVA HEART, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MILFORD STREET
SALISBURY MD
21804
US

IV. Provider business mailing address

106 MILFORD ST
SALISBURY MD
21804-6953
US

V. Phone/Fax

Practice location:
  • Phone: 410-334-2227
  • Fax: 410-334-6128
Mailing address:
  • Phone: 410-334-2227
  • Fax: 410-334-6128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CINDY WEBSTER
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 410-334-2227