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General NPI Number Information
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NPI Number | 1992809628
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Entity Type | Organization
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Legal Business Name | EASTERN SHORES GASTROENTEROLOGY ASSOC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 33663 BAYVIEW MEDICAL DR UNIT 2
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City | LEWES
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State | DE
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Zip | 19958-1663
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Country | US
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Telephone | 302-645-9325
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Fax | 302-645-5214
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Provider Business Mailing Address
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Address Line | 33663 BAYVIEW MEDICAL DR UNIT 2
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City | LEWES
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State | DE
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Zip | 19958-1663
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Country | US
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Telephone | 302-645-9325
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Fax | 302-645-5214
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Authorized Official
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Title or Position | PHYSICIAN PARTNER
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Name | ROBERT C DECKMANN
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Credential | MD
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Telephone | 302-645-9325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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