Provider Demographics
NPI:1043379290
Name:DELAWARE VASCULAR ASSOCIATES P A
Entity Type:Organization
Organization Name:DELAWARE VASCULAR ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:HARAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-733-5700
Mailing Address - Street 1:4735 OGLETOWN STANTON RD
Mailing Address - Street 2:MEDICAL ARTS PAVILION 2 SUITE 1208
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2072
Mailing Address - Country:US
Mailing Address - Phone:302-733-5700
Mailing Address - Fax:302-733-5373
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:MEDICAL ARTS PAVILION 2 SUITE 1208
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2072
Practice Address - Country:US
Practice Address - Phone:302-733-5700
Practice Address - Fax:302-733-5373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE19982057362086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000014369Medicaid
DE1000014369Medicaid