Provider Demographics
NPI:1174627574
Name:DUQUE-SALVA, NIEVA T (MD)
Entity Type:Individual
Prefix:DR
First Name:NIEVA
Middle Name:T
Last Name:DUQUE-SALVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N BANCROFT PKWY
Mailing Address - Street 2:SUITE LL3
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2690
Mailing Address - Country:US
Mailing Address - Phone:302-655-2048
Mailing Address - Fax:302-543-8945
Practice Address - Street 1:1010 N BANCROFT PKWY
Practice Address - Street 2:SUITE LL3
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2690
Practice Address - Country:US
Practice Address - Phone:302-655-2048
Practice Address - Fax:302-543-8945
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10001601207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000064501Medicaid
DEB66563Medicare UPIN
DE0000064501Medicaid