Provider Demographics
NPI:1013095587
Name:ZARRAGA, ANTONIO L (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:L
Last Name:ZARRAGA
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 1:640 S. STATE STREET
Mailing Address - Street 2:MAIL CODE 3055
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-480-9807
Practice Address - Street 1:101 WELLNESS WAY STE 200
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4366
Practice Address - Country:US
Practice Address - Phone:302-430-0867
Practice Address - Fax:302-430-0421
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI0004034207RI0200X, 207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00A053Z56OtherMEDICARE
DE510401INFOtherBCBS SPECIALIST
DE882215OtherOPTIMUM CHOICE
DE100803OtherCOVENTRY
DEF47539OtherBCBS DE
DE898332OtherAETUS
DE0000459801Medicaid
DE4284720OtherAETNA
F47539Medicare UPIN