Provider Demographics
NPI:1518990142
Name:MEDICAL ASSOCIATES OF BEAR
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF BEAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:O
Authorized Official - Last Name:BADILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-832-6768
Mailing Address - Street 1:PO BOX 7079
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19714-7079
Mailing Address - Country:US
Mailing Address - Phone:302-832-6768
Mailing Address - Fax:302-283-1289
Practice Address - Street 1:1450 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5108
Practice Address - Country:US
Practice Address - Phone:302-832-6768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10006141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty