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Contact Information

ADOLESCENT MEDICINE GENERAL PEDIATRICS & ALLERGY
863 BUTTNER PLACE
SUITE 103
DOVER, DE19904-2406
 Phone: 302-734-3331
 Fax: 302-734-9908
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ADOLESCENT MEDICINE GENERAL PEDIATRICS & ALLERGY

NPI Number 1053450981
LBN Legal business name ADOLESCENT MEDICINE GENERAL PEDIATRICS & ALLERGY
Authorized official FIZUL BACCHUS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
DE Medicaid 0001036904
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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