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General NPI Number Information
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NPI Number | 1871661041
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Entity Type | Individual
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Provider Name | UDAY S UTHAMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 2055 LIMESTONE RD SUITE 201
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City | WILMINGTON
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State | DE
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Zip | 19808-5536
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Country | US
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Telephone | 302-737-0800
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Fax | 302-738-4914
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Provider Business Mailing Address
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Address Line | PO BOX 8252
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City | NEWARK
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State | DE
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Zip | 19714-8252
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Country | US
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Telephone | 302-737-0800
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Fax | 302-738-8169
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25MA05838200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | C1-0004306
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License Number State | DE
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