State of Delaware

NPI #1104984525 in Dover, Delaware

Provider Information

NPI Number: 1104984525
Entity Type: Organization
Organization Name: State of Delaware
Primary Specialty: Clinic/Center - Student Health
Enumeration Date: Dec 5, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 417 FEDERAL ST
City: Dover
State: Delaware
ZIP Code: 19901-3635
Phone: (302) 744-4849

Authorized Official

Name: HERMAN ELLIS, MD
Title: MEDICAL DIRECTOR
Phone: (302) 744-4700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Student Health — Student Health	261QS1000X	Primary

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Provider Name	Specialty	City
State of Delaware	Clinic/Center - Student Health	Dover	AI Deep Dive
State of Delaware	Clinic/Center - Student Health	Dover	AI Deep Dive
State of Delaware	Clinic/Center - Student Health	Dover	AI Deep Dive
State of Delaware	Clinic/Center - Student Health	Dover	AI Deep Dive

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