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General NPI Number Information
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NPI Number | 1043323900
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Entity Type | Organization
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Legal Business Name | BRANDYWINE INTERNAL MEDICINE
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1805 FOULK RD SUITE G
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City | WILMINGTON
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State | DE
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Zip | 19810-3700
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Country | US
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Telephone | 302-475-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 FOULK RD SUITE G
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City | WILMINGTON
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State | DE
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Zip | 19810-3700
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Country | US
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Telephone | 302-475-3131
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ANDREW NASH
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Credential | D.O.
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Telephone | 302-475-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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