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General NPI Number Information
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NPI Number | 1477561306
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Entity Type | Organization
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Legal Business Name | CLINIC BY THE SEA LLC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 16295 WILLOW CREEK RD
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City | LEWES
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State | DE
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Zip | 19958-3614
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Country | US
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Telephone | 302-644-0999
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Fax | 302-644-3099
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Provider Business Mailing Address
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Address Line | 16295 WILLOW CREEK RD
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City | LEWES
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State | DE
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Zip | 19958-3614
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Country | US
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Telephone | 302-644-0999
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Fax | 302-644-3099
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Authorized Official
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Title or Position | CO PRESIDENT
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Name | GEORGES A DAHR
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Credential | MD
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Telephone | 302-644-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C1-0005201
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License Number State | DE
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