Provider Demographics
NPI:1811967490
Name:DELAWARE EYE M.D'S ASSOCIATES
Entity type:Organization
Organization Name:DELAWARE EYE M.D'S ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-992-0430
Mailing Address - Street 1:2055 LIMESTONE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5536
Mailing Address - Country:US
Mailing Address - Phone:302-992-0430
Mailing Address - Fax:302-992-0461
Practice Address - Street 1:2055 LIMESTONE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5536
Practice Address - Country:US
Practice Address - Phone:302-992-0430
Practice Address - Fax:302-992-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000973802Medicaid
DE0000973802Medicaid
DED01140Medicare UPIN