Healthcare Provider Details

I. General information

NPI: 1215219704
Provider Name (Legal Business Name): BRANDYWINE PODIATRY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 SILVERSIDE RD STE 201
WILMINGTON DE
19810-4164
US

IV. Provider business mailing address

1010 N BANCROFT PKWY
WILMINGTON DE
19805-2690
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-8099
  • Fax:
Mailing address:
  • Phone: 302-658-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTOPHER SAVAGE
Title or Position: OWNER
Credential: DPM
Phone: 302-658-1129