Provider Demographics
NPI:1407998040
Name:AZARCON, CONSTANTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:
Last Name:AZARCON
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 1:3411 SILVERSIDE ROAD,
Mailing Address - Street 2:RODNEY BUILDING SUITE 107
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3540
Mailing Address - Country:US
Mailing Address - Phone:302-478-2969
Mailing Address - Fax:
Practice Address - Street 1:3411 SILVERSIDE ROAD,
Practice Address - Street 2:RODNEY BUILDING SUITE 107
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:302-478-2969
Practice Address - Fax:302-351-4031
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00067672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry