Provider Demographics
NPI:1629100813
Name:HAGEE, MARY MARGARETT (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGARETT
Last Name:HAGEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3411 SILVERSIDE RD
Mailing Address - Street 2:WEBSTER BLDG, SUITE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-479-8464
Mailing Address - Fax:302-479-7159
Practice Address - Street 1:3411 SILVERSIDE RD
Practice Address - Street 2:WEBSTER BUILDING, STE 103
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-479-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0008977207Q00000X
PAOS008923L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine