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General NPI Number Information
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NPI Number | 1851346126
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE OF DELAWARE,LLC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 11/24/2009
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Provider Practice Location Address
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Address Line | 1001 S BRADFORD ST STE 9
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City | DOVER
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State | DE
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Zip | 19904-4153
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Country | US
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Telephone | 302-744-9645
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Fax | 302-744-9649
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Provider Business Mailing Address
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Address Line | 1001 S BRADFORD ST STE 9
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City | DOVER
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State | DE
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Zip | 19904-4153
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Country | US
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Telephone | 302-744-9645
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Fax | 302-744-9649
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Authorized Official
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Title or Position | MD
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Name | VINEET PURI
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Credential | MD
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Telephone | 302-744-9645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C10005512
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License Number State | DE
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