MEDICARE: REGIS PAUL PHELAN PA-C

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
1	363A00000X	Physician Assistant	C5-0000734	DE

General Provider Information

NPI Number	:	1144537093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGIS PAUL PHELAN PA-C

Provider Business Mailing Address
First Line	:	211 EXECUTIVE DR STE 11
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19702-3358
Country	:	US
Telephone Number	:	302-731-2888
Fax Number	:	302-731-7049

Provider Business Practice Location Address
First Line	:	285 BEISER BLVD STE 201
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19904-7804
Country	:	US
Telephone Number	:	302-731-2888
Fax Number	:	302-731-7049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	01/25/2024

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Directions to “ REGIS PAUL PHELAN PA-C” Practice Location

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