Healthcare Provider Details

I. General information

NPI: 1982616496
Provider Name (Legal Business Name): BRUCE ZANGWILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 KIRKWOOD HWY
WILMINGTON DE
19805-4917
US

IV. Provider business mailing address

2037 HAWTHORNE PL
PAOLI PA
19301-1050
US

V. Phone/Fax

Practice location:
  • Phone: 302-994-2511
  • Fax: 302-633-5207
Mailing address:
  • Phone: 610-408-9472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD044262L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: