Individual provider · NPI-1

A Douglas Chervenak, D.O.

Family Medicine · Smyrna, DE

NPI number1356491484
StatusActive
Last updated in NPPESAug 3, 2022

Details

NPI
1356491484
Entity type
Individual (NPI-1)
Name
A Douglas Chervenak
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jan 11, 2007
Certification date
Aug 3, 2022
Last updated
Aug 3, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineC2-0003255DEYes

Practice location

671 S Carter Rd Ste 12
Smyrna, DE 19977-7727

Phone 302-653-1050 · Fax 302-653-1089

Mailing address

319 N Carters Rd
Smyrna, DE 19977-1282

Phone 302-653-1050 · Fax 302-653-1089

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