Provider Demographics
NPI:1538297569
Name:WAVREK, DOROTHY J (MD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:J
Last Name:WAVREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:SUITE 2300 - PHYSICIAN CONTRACTING
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:610-388-9559
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:CHRISTINA HOSPITAL
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-6500
Practice Address - Fax:302-733-2711
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD431930208000000X
DECI-0011002208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics