Provider Demographics
NPI:1982765723
Name:THE DELAWARE CENTER FOR MATERNAL AND FETAL MEDICINE, LLC
Entity Type:Organization
Organization Name:THE DELAWARE CENTER FOR MATERNAL AND FETAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-731-0260
Mailing Address - Street 1:774 CHRISTIANA RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4236
Mailing Address - Country:US
Mailing Address - Phone:302-731-0260
Mailing Address - Fax:302-731-0261
Practice Address - Street 1:774 CHRISTIANA RD
Practice Address - Street 2:SUITE 109
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4236
Practice Address - Country:US
Practice Address - Phone:302-731-0260
Practice Address - Fax:302-731-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10003400207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEF19988Medicare UPIN