Healthcare Provider Details

I. General information

NPI: 1578936290
Provider Name (Legal Business Name): BRANDYWINE PODIATRY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BECKS WOODS DR STE 201
BEAR DE
19701-3851
US

IV. Provider business mailing address

1010 N BANCROFT PKWY STE 12
WILMINGTON DE
19805-2690
US

V. Phone/Fax

Practice location:
  • Phone: 302-595-4077
  • Fax: 302-595-4085
Mailing address:
  • Phone: 302-658-1129
  • Fax: 302-658-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateDE

VIII. Authorized Official

Name: DR. CHRISTOPHER LEIGH SAVAGE
Title or Position: PRESIDENT OWNER
Credential: DPM
Phone: 302-658-1129