Provider Demographics
NPI:1588755961
Name:UN, DOLORES L (MD)
Entity type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:L
Last Name:UN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:CORPORATE CREDENTIALING
Mailing Address - Street 2:P.O. BOX 269
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19899
Mailing Address - Country:US
Mailing Address - Phone:302-651-5938
Mailing Address - Fax:302-651-6077
Practice Address - Street 1:NEMOURS PEDIATRICS PEOPLES PLAZA
Practice Address - Street 2:1400 PEOPLES PLAZA STE. 300
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702
Practice Address - Country:US
Practice Address - Phone:302-836-7820
Practice Address - Fax:302-836-7826
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
DEC10002569208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1594850 (PA)Medicaid
G84587Medicare UPIN