Provider Demographics
NPI:1568034775
Name:I AM HEALTHCARE
Entity Type:Organization
Organization Name:I AM HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-784-5662
Mailing Address - Street 1:59 IVY GLEN CT
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4049
Mailing Address - Country:US
Mailing Address - Phone:302-784-5662
Mailing Address - Fax:
Practice Address - Street 1:951 FOREST ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3401
Practice Address - Country:US
Practice Address - Phone:302-784-5662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty