Eastern Shores Gastroenterology Assoc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

EASTERN SHORES GASTROENTEROLOGY ASSOC

Practice address

33663 Bayview Medical Dr
Unit 2
Lewes, DE 19958-1663

Phone

(302) 645-9325

Fax

(302) 645-5214

NPI assigned

Sep 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert C Deckmann, MD

Title

Physician Partner

Phone

(302) 645-9325

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992809628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33663 BAYVIEW MEDICAL DR",
            "address_2": "UNIT 2",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581663",
            "telephone_number": "302-645-9325",
            "fax_number": "302-645-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33663 BAYVIEW MEDICAL DR",
            "address_2": "UNIT 2",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581663",
            "telephone_number": "302-645-9325",
            "fax_number": "302-645-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORES GASTROENTEROLOGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DECKMANN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN PARTNER",
        "authorized_official_telephone_number": "302-645-9325",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000513804",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Lewes, DE
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.