Provider Demographics
NPI:1417084989
Name:CENTERS, NATHAN LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:LAWRENCE
Last Name:CENTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:156 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7314
Mailing Address - Country:US
Mailing Address - Phone:302-674-2380
Mailing Address - Fax:302-691-1100
Practice Address - Street 1:156 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7314
Practice Address - Country:US
Practice Address - Phone:302-674-2380
Practice Address - Fax:302-691-1100
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI00059522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001104101Medicaid
DE0001104101Medicaid
DE617330Medicare PIN