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General NPI Number Information
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NPI Number | 1568574044
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Entity Type | Organization
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Legal Business Name | DYER MEDICAL CLINIC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2300 PENNSYLVANIA AVE STE 4C
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City | WILMINGTON
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State | DE
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Zip | 19806-1392
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Country | US
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Telephone | 302-658-4270
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Fax | 302-658-4290
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Provider Business Mailing Address
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Address Line | 2300 PENNSYLVANIA AVE STE 4C
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City | WILMINGTON
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State | DE
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Zip | 19806-1392
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Country | US
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Telephone | 302-658-4270
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Fax | 302-658-4290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT ALLEN DYER
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Credential | DO
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Telephone | 302-658-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | C2-0007556
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License Number State | DE
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