Joan Couch
Individual provider Active NPI Specialist · Newark, DE
NPI 1629514567 · NPPES record last updated Jan 17, 2017
Key facts
- NPI
- 1629514567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- J3-0000007 (DE)
- Practice address
- 113 Country Club Dr
Newark, DE 19711-2736 - Phone
- (302) 229-8528
- NPI assigned
- Jan 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J3-0000007 | DE | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | J3-0000007 | DE | Yes |
Addresses
Primary practice location
113 Country Club Dr
Newark, DE 19711-2736
Mailing address
113 Country Club Dr
Newark, DE 19711-2736
Phone (302) 229-8528
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2017. 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.