| Delaware Medical Group, LLC | |
|
4512 Kirkwood Hwy Ste 205 Wilmington DE 19808-5123 | |
| (302) 660-7302 | |
| (302) 995-5426 |
| Full Name | Delaware Medical Group, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4512 Kirkwood Hwy Ste 205, Wilmington, Delaware |
| Authorized Official Name and Position | Stuart Felzer (PRESIDENT) |
| Authorized Official Contact | 3026331442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delaware Medical Group, LLC 4512 Kirkwood Hwy Ste 205 Wilmington DE 19808-5123 Ph: (302) 660-7302 | Delaware Medical Group, LLC 4512 Kirkwood Hwy Ste 205 Wilmington DE 19808-5123 Ph: (302) 660-7302 |
| NPI Number | 1376581363 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Medicare PECOS PAC ID | 0345235578 |
|---|---|
| Medicare Enrollment ID | O20040417000257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376581363 | NPI | - | NPPES |
| 0001195402 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | (Delaware) | Secondary |
| Provider Name | Jill E Mackey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578505863 PECOS PAC ID: 7911962881 Enrollment ID: I20041120000073 |
| Provider Name | Mary a High |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457350019 PECOS PAC ID: 1557430014 Enrollment ID: I20080523000223 |
| Provider Name | Stuart Felzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508804402 PECOS PAC ID: 6406841642 Enrollment ID: I20110315001014 |
| Provider Name | Kevin O Hara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538100672 PECOS PAC ID: 7416942651 Enrollment ID: I20110411000477 |
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