Provider Demographics
NPI:1518421403
Name:SEAFORD INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:SEAFORD INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GORRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
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:19947-1424
Mailing Address - Country:US
Mailing Address - Phone:302-855-0915
Mailing Address - Fax:302-855-0914
Practice Address - Street 1:10 W LAUREL ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1424
Practice Address - Country:US
Practice Address - Phone:302-855-0915
Practice Address - Fax:302-855-0914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies