Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | C10002023 | DE |
N | 207ND0900X | Dermatopathologist | C10002023 | DE |
NPI | 1780619270 |
---|---|
Provider Name | Maurice A Thew |
First Address | Wilmington, DE 19804-0012 |
Second Address | Wilmington, DE 19810-4932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D01031 | (02) |