Provider Demographics
NPI:1043372857
Name:CIARLO, ALFONSO PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFONSO
Middle Name:PAUL
Last Name:CIARLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4710
Mailing Address - Country:US
Mailing Address - Phone:302-475-2535
Mailing Address - Fax:302-475-2720
Practice Address - Street 1:5311 LIMESTONE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-234-2200
Practice Address - Fax:302-234-2262
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI0000332207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000107001Medicaid
B66338Medicare UPIN
DE0000107001Medicaid