Provider Demographics
NPI:1851451298
Name:LOMBARDI, ANTHONY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CHARLES
Last Name:LOMBARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4710
Mailing Address - Country:US
Mailing Address - Phone:302-475-2535
Mailing Address - Fax:302-475-2720
Practice Address - Street 1:2101 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4710
Practice Address - Country:US
Practice Address - Phone:302-475-2535
Practice Address - Fax:302-475-2720
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0932207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000024704Medicaid
DE00B478D60Medicare ID - Type Unspecified
DE1000024704Medicaid