Provider Demographics
NPI:1912215542
Name:DELAWARE PLASTIC SURGERY PA
Entity Type:Organization
Organization Name:DELAWARE PLASTIC SURGERY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:302-674-4865
Mailing Address - Street 1:200 BANNING ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3485
Mailing Address - Country:US
Mailing Address - Phone:302-674-4865
Mailing Address - Fax:
Practice Address - Street 1:200 BANNING ST
Practice Address - Street 2:SUITE 230
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3485
Practice Address - Country:US
Practice Address - Phone:302-674-4865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00056402086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty