Provider Demographics
NPI:1598842676
Name:CHAMBERS, PHYLLIS E (DO)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:E
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1332
Mailing Address - Country:US
Mailing Address - Phone:302-475-3346
Mailing Address - Fax:302-529-1526
Practice Address - Street 1:1401 SILVERSIDE RD
Practice Address - Street 2:SUITE C
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4400
Practice Address - Country:US
Practice Address - Phone:302-475-3346
Practice Address - Fax:302-529-1526
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI30001162152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000202922Medicaid
DE414628Medicare ID - Type Unspecified