Elvis Amadi

Individual provider Active NPI Specialist · Dover, DE

NPI 1770943201 · NPPES record last updated Feb 25, 2016

Key facts

NPI
1770943201
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
MT.0004153 (DE)
Practice address
1027 S Bradford St
Dover, DE 19904-4141
Phone
(302) 465-8253
NPI assigned
Feb 25, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT.0004153DEMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MT.0004153 DE Yes

Addresses

Primary practice location

1027 S Bradford St
Dover, DE 19904-4141

Mailing address

1027 S Bradford St
Dover, DE 19904-4141

Other providers in Dover, DE

All providers in Dover, DE · Specialist in Delaware

Sources for this page

Verify at the official NPI Registry.