Healthcare Provider Details

I. General information

NPI: 1831216746
Provider Name (Legal Business Name): MATTHEW DAN EICHENBAUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 LIMESTONE RD STE 101
WILMINGTON DE
19808-5413
US

IV. Provider business mailing address

1941 LIMESTONE RD STE 101
WILMINGTON DE
19808-5413
US

V. Phone/Fax

Practice location:
  • Phone: 302-655-9494
  • Fax: 302-691-1478
Mailing address:
  • Phone: 302-655-9494
  • Fax: 302-633-3559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD432176
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberC1-0009482
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC1-0009482
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: