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General NPI Number Information
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NPI Number | 1518016831
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Entity Type | Organization
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Legal Business Name | SEAFORD INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 04/02/2018
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Provider Practice Location Address
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Address Line | 1501 MIDDLEFORD RD
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City | SEAFORD
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State | DE
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Zip | 19973-3615
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Country | US
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Telephone | 302-629-4569
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Fax | 302-628-4669
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Provider Business Mailing Address
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Address Line | 10 W LAUREL ST
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City | GEORGETOWN
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State | DE
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Zip | 19947
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Country | US
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Telephone | 302-855-0915
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Fax | 302-855-0914
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JONA GORRA
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Credential |
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Telephone | 302-855-0915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C10005098
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License Number State | DE
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