Provider Demographics
NPI:1518016831
Name:SEAFORD INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:SEAFORD INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JONA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-855-0915
Mailing Address - Street 1:10 W LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947
Mailing Address - Country:US
Mailing Address - Phone:302-855-0915
Mailing Address - Fax:302-855-0914
Practice Address - Street 1:1501 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3615
Practice Address - Country:US
Practice Address - Phone:302-629-4569
Practice Address - Fax:302-628-4669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty