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General NPI Number Information
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NPI Number | 1780080770
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Entity Type | Organization
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Legal Business Name | GOVERNORS FAMILY PRACTICE P.A
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 1177A S GOVERNORS AVE
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City | DOVER
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State | DE
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Zip | 19904-6903
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Country | US
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Telephone | 302-734-9150
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Fax | 302-380-7600
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Provider Business Mailing Address
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Address Line | 1177A S GOVERNORS AVE
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City | DOVER
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State | DE
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Zip | 19904-6903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THUYA AYE
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Credential | M.D.
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Telephone | 302-734-9150
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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 |
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License Number State |
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