Provider Demographics
NPI:1871651380
Name:DELAWARE MEDICAL ASSOCIATES P.A.
Entity Type:Organization
Organization Name:DELAWARE MEDICAL ASSOCIATES P.A.
Other - Org Name:DR. ARMAND NEAL DESANCTIS JR MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMAND
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:DESANCTIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:302-475-3385
Mailing Address - Street 1:2101 FOULK ROAD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-475-3385
Mailing Address - Fax:302-475-2720
Practice Address - Street 1:2101 FOULK ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:302-475-3385
Practice Address - Fax:302-475-2720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000062300LMedicaid
DE000062300LMedicaid