Provider Demographics
NPI:1891793352
Name:TEMPLE, JOEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:R
Last Name:TEMPLE
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 1:9 E LOOCKERMAN ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-8306
Mailing Address - Country:US
Mailing Address - Phone:302-678-1343
Mailing Address - Fax:302-678-1344
Practice Address - Street 1:9 E LOOCKERMAN ST
Practice Address - Street 2:SUITE 303
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-8306
Practice Address - Country:US
Practice Address - Phone:302-678-1343
Practice Address - Fax:302-678-1344
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1 0000597207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000021401Medicaid
DE0000021401Medicaid
DED01159Medicare UPIN