Provider Demographics
NPI:1679553580
Name:SOWA, DAVID T (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:SOWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:211 EXECUTIVE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3358
Mailing Address - Country:US
Mailing Address - Phone:302-731-2888
Mailing Address - Fax:302-731-7049
Practice Address - Street 1:4051 OGLETOWN RD STE 103
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3101
Practice Address - Country:US
Practice Address - Phone:302-731-2888
Practice Address - Fax:302-731-7049
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DECI0002928207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000065701Medicaid
DE041929F17Medicare ID - Type Unspecified
DE000065701Medicaid