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General NPI Number Information
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NPI Number | 1922134899
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Entity Type | Organization
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Legal Business Name | ABIGAIL MEDICAL FAMILY MEDICINE, L.L.C.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 412 SUBURBAN DR
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City | NEWARK
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State | DE
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Zip | 19711-3564
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Country | US
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Telephone | 302-738-3770
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Fax | 302-738-4749
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Provider Business Mailing Address
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Address Line | 412 SUBURBAN DR
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City | NEWARK
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State | DE
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Zip | 19711-3564
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Country | US
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Telephone | 302-738-3770
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Fax | 302-738-4749
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. JAMES CLARK HORAH
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Credential |
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Telephone | 302-738-3770
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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 | C20005526
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License Number State | DE
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