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General NPI Number Information
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NPI Number | 1457599052
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Entity Type | Organization
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Legal Business Name | ABG MEDICINE, PLLC
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 742 S GOVERNORS AVE SUITE 2
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City | DOVER
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State | DE
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Zip | 19904-4111
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Country | US
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Telephone | 302-678-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 17 PENNWOOD DR
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City | DOVER
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State | DE
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Zip | 19901-5848
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Country | US
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Telephone | 302-535-8490
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SENAD CEMERLIC
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Credential | M.D.
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Telephone | 302-535-8490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C1-0008124
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License Number State | DE
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