Provider Demographics
NPI:1366503096
Name:LIMESTONE MEDICAL & PEDIATRIC ASSOC, P.A.
Entity type:Organization
Organization Name:LIMESTONE MEDICAL & PEDIATRIC ASSOC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-992-9617
Mailing Address - Street 1:4512 KIRKWOOD HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5123
Mailing Address - Country:US
Mailing Address - Phone:302-992-9617
Mailing Address - Fax:302-992-9633
Practice Address - Street 1:4512 KIRKWOOD HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5123
Practice Address - Country:US
Practice Address - Phone:302-992-9617
Practice Address - Fax:302-992-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000546402Medicaid
DE681540Medicare PIN