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General NPI Number Information
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NPI Number | 1255435343
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Entity Type | Organization
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Legal Business Name | UROLOGIC SURGICAL ASSOCIATES OF DELAWARE
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 1815 W 13TH ST THE STATION SUITE 4
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City | WILMINGTON
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State | DE
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Zip | 19806-4054
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Country | US
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Telephone | 302-517-8958
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Fax | 302-571-1320
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Provider Business Mailing Address
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Address Line | 1815 W 13TH ST THE STATION SUITE 4
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City | WILMINGTON
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State | DE
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Zip | 19806-4054
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Country | US
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Telephone | 302-517-8958
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Fax | 302-571-1320
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Authorized Official
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Title or Position | PRESIDENT GROUP ADMINISTRATOR
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Name | FRANCIS JACKSON SCHANNE
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Credential | MD
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Telephone | 302-571-8958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 2003100929
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License Number State | DE
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