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General NPI Number Information
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NPI Number | 1033435151
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Entity Type | Organization
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Legal Business Name | MID ATLANTIC WOUNDSPECIALISTS, LLC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 13 SIGNAL HILL DR
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City | HOCKESSIN
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State | DE
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Zip | 19707-1416
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Country | US
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Telephone | 302-234-6530
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Fax | 302-234-6530
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Provider Business Mailing Address
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Address Line | 227 UPPER PIKE CREEK RD
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City | NEWARK
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State | DE
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Zip | 19711-5955
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Country | US
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Telephone | 302-234-6530
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Fax | 302-234-6530
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Authorized Official
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Title or Position | PARTNER
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Name | RODNEY P DONHAM
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Credential | D.O.
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Telephone | 302-234-6530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C2-0004610
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License Number State | DE
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