Healthcare Provider Details

I. General information

NPI: 1538573837
Provider Name (Legal Business Name): THE VEIN CENTER AT EDEN HILL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST SUITE 300
DOVER DE
19904-3485
US

IV. Provider business mailing address

200 BANNING ST STE 300
DOVER DE
19904-3488
US

V. Phone/Fax

Practice location:
  • Phone: 302-735-8850
  • Fax: 302-735-8851
Mailing address:
  • Phone: 302-735-8850
  • Fax: 302-735-8851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0006274
License Number StateDE

VIII. Authorized Official

Name: DR. BRANDT J FEUERSTEIN
Title or Position: OWNER
Credential: MD
Phone: 302-735-8850