Provider Demographics
NPI:1417769217
Name:PREMIER MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:PREMIER MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYRON
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:DEPUTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-652-5109
Mailing Address - Street 1:620 STANTON CHRISTIANA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2134
Mailing Address - Country:US
Mailing Address - Phone:302-449-9314
Mailing Address - Fax:877-575-3337
Practice Address - Street 1:1408 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1623
Practice Address - Country:US
Practice Address - Phone:302-652-5109
Practice Address - Fax:877-575-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic