=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679632558
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTIANA CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2006
-----------------------------------------------------
Last Update Date | 06/24/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1001 SEWELL BRANCH ROAD
-----------------------------------------------------
City | CLAYTON
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-981-9931
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 S. MAIN ST. SUITE 101
-----------------------------------------------------
City | SMYRNA
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19977
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-659-4545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. DEAN DOBBERT
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 302-428-4250
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | LG-0000201
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------