MEDICARE: MRS. HEATHER L. DEALY MD

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	207W00000X	Ophthalmology Physician	MD42405	PA
2	207W00000X	Ophthalmology Physician	C1-0007303	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265424170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER L. DEALY MD

Provider Business Mailing Address
First Line	:	1941 LIMESTONE RD
Second Line	:	SUITE 200
City	:	WILMINGTON
State	:	DE
Zip	:	19808-5408
Country	:	US
Telephone Number	:	302-998-2333
Fax Number	:	302-998-3277

Provider Business Practice Location Address
First Line	:	1941 LIMESTONE RD
Second Line	:	SUITE 200
City	:	WILMINGTON
State	:	DE
Zip	:	19808-5408
Country	:	US
Telephone Number	:	302-998-2333
Fax Number	:	302-998-3277

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	02/20/2014

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Directions to “ MRS. HEATHER L. DEALY MD” Practice Location

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