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General NPI Number Information
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NPI Number | 1013236207
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Entity Type | Individual
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Provider Name | DANITA RENELSA FOX M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 2 SHARPE STREET
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City | KINGSTON
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State | PA
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Zip | 18704
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Country | US
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Telephone | 570-552-8966
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Fax | 570-552-8958
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Provider Business Mailing Address
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Address Line | 54 WOODWARD DR
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City | WILMINGTON
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State | DE
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Zip | 19808-4342
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Country | US
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Telephone | 302-561-4308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT196357
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License Number State | PA
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