Provider Demographics
NPI:1568797389
Name:DELAWARE OB GYN AMD WOMENS HEALTH
Entity Type:Organization
Organization Name:DELAWARE OB GYN AMD WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:UMOBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-730-0633
Mailing Address - Street 1:1057 S BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4141
Mailing Address - Country:US
Mailing Address - Phone:302-730-0633
Mailing Address - Fax:
Practice Address - Street 1:1057 S BRADFORD ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4141
Practice Address - Country:US
Practice Address - Phone:302-730-0633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty