Vonda Goslee Green, M.D.
Individual provider Active NPI Family Medicine Physician · Woodside, DE
NPI 1205957677 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205957677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- C1-0004549 (DE)
- Practice address
- 823 Walnut Shade Road
Woodside, DE 19980 - Phone
- (302) 697-8402
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0004549 | DE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delmarva Rural Ministries, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C1-0004549 | DE | Yes |
Addresses
Primary practice location
823 Walnut Shade Road
Woodside, DE 19980
Mailing address
608 Raven Cir
Wyoming, DE 19934-4021
Phone (302) 698-2150
Other providers in Woodside, DE
All providers in Woodside, DE · Family Medicine Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.