Basic Information
| Provider Information | |||||||||
| NPI: | 1497105332 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOHLER | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 FOULK RD STE 100B | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198032764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024773300 | ||||||||
| FaxNumber: | 3024773168 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 FOULK RD STE 100B | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198032764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024773300 | ||||||||
| FaxNumber: | 3024773168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2016 | ||||||||
| LastUpdateDate: | 07/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | LP03787 | RI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | C1-0013758 | DE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.