Provider Demographics
NPI:1588680136
Name:DELAWARE GYNECOLOGY
Entity Type:Organization
Organization Name:DELAWARE GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-454-1222
Mailing Address - Street 1:2707 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-6828
Mailing Address - Country:US
Mailing Address - Phone:302-454-1222
Mailing Address - Fax:302-737-4263
Practice Address - Street 1:2707 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-6828
Practice Address - Country:US
Practice Address - Phone:302-454-1222
Practice Address - Fax:302-737-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1001616207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty