NPI 1023147493

Crestview Medical Center P a

Organisation Preferred Provider Organization Wilmington, DE

Practice location

Address: 1800 N Broom St Suite 109, Wilmington, DE 19802-3809
Phone: (302) 762-4545
Fax: (302) 762-9086

Authorised official

Name: Clement A. Ogunwande
Title: Medical Director
Phone: (302) 762-4545

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence C2-0004996 (DE)

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Registry record

NPI: 1023147493
Entity type: Organization
NPI issued: 3 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.