Provider Demographics
NPI:1962860882
Name:DELAWARE FAMILY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:DELAWARE FAMILY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUSEYI
Authorized Official - Middle Name:N
Authorized Official - Last Name:SENU-OKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-275-5089
Mailing Address - Street 1:2500 WRANGLE HILL RD STE 2
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-3836
Mailing Address - Country:US
Mailing Address - Phone:302-275-5089
Mailing Address - Fax:302-838-3140
Practice Address - Street 1:2500 WRANGLE HILL RD STE 2
Practice Address - Street 2:SUITE 205
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-3836
Practice Address - Country:US
Practice Address - Phone:302-275-5089
Practice Address - Fax:302-838-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10002811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty