Healthcare Provider Details

I. General information

NPI: 1043285471
Provider Name (Legal Business Name): MANMEET BRAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1198 S GOVERNORS AVE STE B100
DOVER DE
19904-6930
US

IV. Provider business mailing address

4923 OGLETOWN STANTON RD SUITE 200
NEWARK DE
19713-2081
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-3227
  • Fax: 302-734-0391
Mailing address:
  • Phone: 302-225-0451
  • Fax: 302-225-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC10006055
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0006055
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: