Provider Demographics
NPI:1235463548
Name:FIRST STATE PEDIATRICS, LLC
Entity Type:Organization
Organization Name:FIRST STATE PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:302-292-1559
Mailing Address - Street 1:210 CHRISTIANA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1652
Mailing Address - Country:US
Mailing Address - Phone:302-292-1559
Mailing Address - Fax:
Practice Address - Street 1:210 CHRISTIANA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1652
Practice Address - Country:US
Practice Address - Phone:302-292-1559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006030208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty