Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | C1-0010445 | DE |
Y | 111NI0900X | Internist | C1-0010445 | DE |
N | 207R00000X | Internist | D74134 | MD |
N | 111NI0900X | Internist | D74134 | MD |
N | 207RG0300X | Geriatric Medicine | C1-0010445 | DE |
N | 207RG0300X | Geriatric Medicine | D74134 | MD |
NPI | 1023278694 |
---|---|
Provider Name | Dr. Melissa D. Morgan-Gouveia |
First Address | Wilmington, DE 19801-1013 |
Second Address | Wilmington, DE 19801-1013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 08/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
56563600 | (05) | MD |