Provider Demographics
NPI:1144255647
Name:THEW, MARGUERITE (MD)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:THEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3012
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-0012
Mailing Address - Country:US
Mailing Address - Phone:302-224-5678
Mailing Address - Fax:302-224-2848
Practice Address - Street 1:3516 SILVERSIDE RD
Practice Address - Street 2:19 THE COMMONS
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4932
Practice Address - Country:US
Practice Address - Phone:302-478-1213
Practice Address - Fax:302-478-2274
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI-0001629207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE562697T78Medicare ID - Type Unspecified
E203059Medicare UPIN