Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | OT011869 | PA |
N | 208600000X | Surgeon | OT011869 | PA |
Y | 2086S0102X | Surgical Critical Care | C2-0010151 | DE |
NPI | 1093033482 |
---|---|
Provider Name | Luis Cardenas, Do |
First Address | Wilmington, DE 19805-7170 |
Second Address | Newark, DE 19713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 03/10/2012 |