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General NPI Number Information
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NPI Number | 1962495838
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Entity Type | Organization
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Legal Business Name | BAYHEALTH MEDICAL CENTER / KENT GENERAL HOSPITAL
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 640 S STATE ST
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City | DOVER
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State | DE
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Zip | 19901-3530
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Country | US
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Telephone | 302-744-7039
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Fax | 302-735-3848
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Provider Business Mailing Address
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Address Line | 15 GOLDENROD LN
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City | MAGNOLIA
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State | DE
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Zip | 19962-9365
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Country | US
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Telephone | 302-335-1380
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT MEDICAL AFFAIRS
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Name | DR. ANTHONY F. OLIVA
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Credential | D.O.
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Telephone | 302-744-7039
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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 | C20006782
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License Number State | DE
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