Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | C20005060 | DE |
NPI | 1063450609 |
---|---|
Provider Name | Robert G Locke |
First Address | Newark, DE 19713-2067 |
Second Address | Newark, DE 19713-2067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 24/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000794503 | (05) | DE |
F02936 | (02) |