Provider Demographics
NPI:1417946211
Name:WINGEL, DEBORAH A (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:WINGEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 YORKLYN RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8731
Mailing Address - Country:US
Mailing Address - Phone:302-239-6200
Mailing Address - Fax:302-239-6238
Practice Address - Street 1:724 YORKLYN RD
Practice Address - Street 2:SUITE 125
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8731
Practice Address - Country:US
Practice Address - Phone:302-239-6200
Practice Address - Fax:302-239-6238
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0003532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEE86605Medicare UPIN
DE673264Medicare ID - Type Unspecified