Provider Demographics
NPI:1326110511
Name:CAREY, STEPHEN DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DANIEL
Last Name:CAREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 N SHIPLEY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-2339
Mailing Address - Country:US
Mailing Address - Phone:302-629-8662
Mailing Address - Fax:302-629-7661
Practice Address - Street 1:543 N SHIPLEY ST
Practice Address - Street 2:SUITE A
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-2339
Practice Address - Country:US
Practice Address - Phone:302-629-8662
Practice Address - Fax:302-629-7661
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003913208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000414801Medicaid
DE0000414801Medicaid
DEF30927Medicare UPIN