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General NPI Number Information
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NPI Number | 1043950686
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Entity Type | Organization
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Legal Business Name | I & O DIABETES CONSULTANTS LLC
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 18766 JOHN J WILLIAMS HWY STE 306
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4417
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Country | US
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Telephone | 302-985-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 CARLTON LN STE B
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City | WILMINGTON
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State | DE
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Zip | 19810-3917
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Country | US
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Telephone | 770-314-2611
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Fax |
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Authorized Official
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Title or Position | DNP
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Name | MIESHIA S CLARK
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Credential | DNP
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Telephone | 770-314-2611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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