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General NPI Number Information
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NPI Number | 1730127820
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Entity Type | Organization
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Legal Business Name | DELAWARE COASTAL ANESTHESIA LLC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 655 S BAY RD STE 5B
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City | DOVER
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State | DE
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Zip | 19901-4660
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Country | US
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Telephone | 302-678-4688
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Fax | 302-678-4625
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Provider Business Mailing Address
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Address Line | PO BOX 785802
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City | PHILADELPHIA
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State | PA
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Zip | 19178-5802
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Country | US
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Telephone | 855-709-4535
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Fax | 302-733-0854
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | RODERICK M RELOVA
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Credential | D.O.
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Telephone | 302-331-4003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | DE
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