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General NPI Number Information
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NPI Number | 1225189095
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Entity Type | Organization
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Legal Business Name | CAPE HENLOPEN DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 750 KINGS HWY SUITE 110
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City | LEWES
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State | DE
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Zip | 19958
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Country | US
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Telephone | 302-644-6400
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Fax | 302-644-6409
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Provider Business Mailing Address
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Address Line | 750 KINGS HWY SUITE 110
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City | LEWES
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State | DE
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Zip | 19958
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Country | US
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Telephone | 302-644-6400
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Fax | 302-644-6409
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MITCHELL C STICKLER
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Credential | MD
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Telephone | 302-644-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | C10003715
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | C50000344
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | C10007095
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License Number State | DE
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