MEDICARE: DELMARVA RADIATION SERVICES, PA

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	2085R0001X	Radiation Oncology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DE4449	OTHER		RAILROAD MEDICARE

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	:	1992740906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELMARVA RADIATION SERVICES, PA

Provider Business Mailing Address
First Line	:	PO BOX 497
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-0497
Country	:	US
Telephone Number	:	302-645-3775
Fax Number	:	302-645-3774

Provider Business Practice Location Address
First Line	:	18947 JOHN J WILLIAMS HWY
Second Line	:
City	:	REHOBOTH BEACH
State	:	DE
Zip	:	19971-4474
Country	:	US
Telephone Number	:	302-645-3775
Fax Number	:	302-645-3774

Authorized Official
Title or Position	:	MEDICAL DIRECTOR/PRESIDENT
Name	:	DR. BRIAN J COSTLEIGH
Credential	:	MD
Telephone Number	:	302-645-3775

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	06/11/2021

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Directions to “DELMARVA RADIATION SERVICES, PA ” Practice Location

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