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NPI Code Detail

MEDICARE: DELAWARE CARDIOVASCULAR ASSOCIATES, P.A.

MEDICARE: DELAWARE CARDIOVASCULAR ASSOCIATES, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1635578OTHERDEMEDICARE PTAN NUMBER

General Provider Information

NPI Number : 1073567418
Entity Type Code : Organization
Provider Name (Legal Business Name) : DELAWARE CARDIOVASCULAR ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 1403 FOULK RD
Second Line : SUITE 101A
City : WILMINGTON
State : DE
Zip : 19803-2788
Country : US
Telephone Number : 302-661-1661
Fax Number : 302-661-1001
Provider Business Practice Location Address
First Line : 1403 FOULK RD
Second Line : SUITE 101
City : WILMINGTON
State : DE
Zip : 19803-2788
Country : US
Telephone Number : 302-661-7676
Fax Number : 302-661-1050
Authorized Official
Title or Position : PRACTICE MANAGER
Name : SHRAVEN PAKANATI
Credential :
Telephone Number : 302-661-1661
Provider Enumeration Date : 05/20/2006
Last Update Date : 03/25/2014

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Directions to “DELAWARE CARDIOVASCULAR ASSOCIATES, P.A. ” Practice Location

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