Basic Information
| Provider Information | |||||||||
| NPI: | 1427193994 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOMURA | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6001 | ||||||||
| Address2: | CHRISTIANA HOSPITAL SUITE, 2A00 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197180001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027331042 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4755 OGLETOWN-STANTON RD | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197180001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027331840 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2007 | ||||||||
| LastUpdateDate: | 08/23/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | C1-0007805 | DE | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | C1-0007805 | DE | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.