NPI
State of Delaware
Phone (302) 744-4849 · Fax (302) 739-6627 · NPI 1104984525
Read from the NPPES registry on October 24, 2026.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2006-12-05
- Last updated
- 2020-08-22
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Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 417 Federal St
- City
- Dover DE
- Postal code
- 19901-3635
- Phone
- (302) 744-4849
- Fax
- (302) 739-6627
Organization contact
- Name
- Herman Ellis
- Title
- Medical Director
- Phone
- (302) 744-4700
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Clinic/Center, Student Health providers in Dover, DE. 21 with this primary taxonomy in the public file.
Other NPIs in Dover, DE. 3,100 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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