Provider Demographics
NPI:1790760593
Name:SMALLS, ARLENE J (MD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:J
Last Name:SMALLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:SMALLS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4755 OGLETOWN STANTON ROAD
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718
Mailing Address - Country:US
Mailing Address - Phone:302-733-6510
Mailing Address - Fax:302-733-3340
Practice Address - Street 1:4755 OGLETOWN STANTON ROAD
Practice Address - Street 2:SUITE 1900
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718
Practice Address - Country:US
Practice Address - Phone:302-733-6510
Practice Address - Fax:302-733-3340
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0004949207V00000X
PAMD432576207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA116153HK1Medicare PIN
DEG28277Medicare UPIN