Provider Demographics
NPI:1720029978
Name:WOMEN'S IMAGING CENTER OF DELAWARE
Entity Type:Organization
Organization Name:WOMEN'S IMAGING CENTER OF DELAWARE
Other - Org Name:AMERICAN OB/GYN
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-738-6202
Mailing Address - Street 1:OMEGA DRIVE J
Mailing Address - Street 2:24
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-738-9100
Mailing Address - Fax:302-292-0204
Practice Address - Street 1:OMEGA DRIVE
Practice Address - Street 2:BUILDING J SUITE 24
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-738-9100
Practice Address - Fax:302-292-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2001719174400000X
DEC10005116174400000X
DEC20005963174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty