Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | C1-0002794 | DE |
NPI | 1205844248 |
---|---|
Provider Name | Stuart Septimus |
First Address | Wilmington, DE 19804-0012 |
Second Address | Wilmington, DE 19808-2147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E52517 | (02) |