PENINSULA PLASTIC SURGERY P.C. NPI 1396991675

NPI Information

  • NPI: 1396991675
  • Provider Name: PENINSULA PLASTIC SURGERY, P.C.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 08D2291725
  • Address: 20930 DUPONT BLVD
    201 GRAY STONE TOWERS
    GEORGETOWN, DE
    ZIP 19947
  • Phone: (410) 546-0464

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NPI Details

PENINSULA PLASTIC SURGERY, P.C. is a specialist in Georgetown, DE. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PENINSULA PLASTIC SURGERY, P.C. NPI is 1396991675. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

20930 DUPONT BLVD
201 GRAY STONE TOWERS
GEORGETOWN, DE
ZIP 19947-725
Phone: (410) 546-0464
Fax: (410) 546-8529

The provider's authorized official is Jill G Taylor .
The authorized official title is Billing Manager and has the following contact phone number (410) 546-0464.

The CLIA number assigned to this NPI record is 08D2291725 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/18/2008 and was last updated on 9/13/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist1997115585DELAWAREYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G00029MEDICARE PINDELAWARE
2G00902MEDICARE OSCAR/CERTIFICATIONDELAWARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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