Provider Demographics
NPI:1821071820
Name:VASILE, ANTHONY A (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:A
Last Name:VASILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W LEA BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2500
Mailing Address - Country:US
Mailing Address - Phone:302-764-2072
Mailing Address - Fax:
Practice Address - Street 1:700 W LEA BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2500
Practice Address - Country:US
Practice Address - Phone:302-764-2072
Practice Address - Fax:302-764-9347
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20002282207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000155004Medicaid
DE0000155004Medicaid
DED98655Medicare UPIN