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General NPI Number Information
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NPI Number | 1780780627
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Entity Type | Organization
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Legal Business Name | SOUTHERN DELAWARE IMAGING ASSOC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 424 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1462
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Country | US
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Telephone | 302-645-3636
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | NASSAU
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State | DE
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Zip | 19969-0070
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Country | US
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Telephone | 302-645-3636
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Fax | 302-645-3133
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Authorized Official
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Title or Position | PARTNER
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Name | ELLEN ALBERT
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Credential |
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Telephone | 302-645-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | DE
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