Provider Demographics
NPI:1962586750
Name:ALDRIDGE, ANNE C (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:C
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 PEOPLES PLAZA
Mailing Address - Street 2:#200
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5708
Mailing Address - Country:US
Mailing Address - Phone:302-832-8181
Mailing Address - Fax:302-832-2181
Practice Address - Street 1:1400 PEOPLES PLAZA
Practice Address - Street 2:#200
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5708
Practice Address - Country:US
Practice Address - Phone:302-832-8181
Practice Address - Fax:302-832-2181
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0002638207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000010601Medicaid
DE00B352A86Medicare PIN
D01168Medicare UPIN