302 BODY SHOP NPI 1811773906

NPI Information

  • NPI: 1811773906
  • Provider Name: 302 BODY SHOP
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Address: 4601 SOUTH DUPONT HIGHWAY
    ST 1
    DOVER, DE
    ZIP 19901
  • Phone: (302) 698-1100

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NPI Details

302 BODY SHOP is a multi-specialty clinic center in Dover, DE. 302 BODY SHOP NPI is 1811773906. The provider is registered as an organization entity type.

The provider's business location address is:

4601 SOUTH DUPONT HIGHWAY
ST 1
DOVER, DE
ZIP 19901
Phone: (302) 698-1100

The provider's authorized official is Ronnie Diem .
The authorized official title is Owner and has the following contact phone number (302) 331-9026.

The enumeration date for this NPI number is 9/5/2023 and was last updated on 9/5/2023.

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
1261QM1300XClinic/CenterMulti-SpecialtyYes

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

NPI Synchronization or Removal

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