Provider Demographics
NPI:1639263452
Name:GARCIA, MARIBEL (MD)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SAVANNAH RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1499
Mailing Address - Country:US
Mailing Address - Phone:302-645-3555
Mailing Address - Fax:302-644-3560
Practice Address - Street 1:124 BROADKILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1008
Practice Address - Country:US
Practice Address - Phone:302-684-2033
Practice Address - Fax:302-684-2036
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10003576207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1639263452Medicaid
DE522011WWHOtherBCBS OF DELAWARE
DE1639263452OtherRAILROAD MEDICAID
DE000000208356OtherUNISON HEALTH CARE
DE1639263452Medicaid
DE1639263452OtherRAILROAD MEDICAID