Provider Demographics
NPI:1962422469
Name:ISMAIL, HUMMAYUN (MD)
Entity type:Individual
Prefix:DR
First Name:HUMMAYUN
Middle Name:
Last Name:ISMAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 STANTON CHRISTIANA RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2131
Mailing Address - Country:US
Mailing Address - Phone:302-633-9033
Mailing Address - Fax:302-633-9032
Practice Address - Street 1:550 STANTON CHRISTIANA RD STE 103
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2131
Practice Address - Country:US
Practice Address - Phone:302-633-9033
Practice Address - Fax:302-633-9032
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005113207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000963901Medicaid
DE58199Medicare UPIN
DE0000963901Medicaid