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General NPI Number Information
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NPI Number | 1710047915
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Entity Type | Organization
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Legal Business Name | FAMILY PHYSICIANS OF WILMINGTON LLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2700 SILVERSIDE RD SUITE 2A
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City | WILMINGTON
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State | DE
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Zip | 19810-3719
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Country | US
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Telephone | 302-478-9191
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Fax | 302-478-9193
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Provider Business Mailing Address
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Address Line | 2700 SILVERSIDE RD SUITE 2A
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City | WILMINGTON
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State | DE
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Zip | 19810-3719
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Country | US
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Telephone | 302-478-9191
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Fax | 302-478-9193
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA SHEEHAN
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Credential | MD
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Telephone | 302-478-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2004211180
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License Number State | DE
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