| Brandywine Family Medicine, Pa | |
|
2500 Grubb Rd Suite 212 Wilmington DE 19810-4799 | |
| (302) 475-5000 | |
| (302) 475-5200 |
| Full Name | Brandywine Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2500 Grubb Rd, Wilmington, Delaware |
| Authorized Official Name and Position | Valerie A. Elener (OWNER) |
| Authorized Official Contact | 3024755000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandywine Family Medicine, Pa 2500 Grubb Rd Suite 212 Wilmington DE 19810-4799 Ph: (302) 475-5000 | Brandywine Family Medicine, Pa 2500 Grubb Rd Suite 212 Wilmington DE 19810-4799 Ph: (302) 475-5000 |
| NPI Number | 1619081627 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 02/20/2013 |
| Medicare PECOS PAC ID | 1951403633 |
|---|---|
| Medicare Enrollment ID | O20070227000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619081627 | NPI | - | NPPES |
| 0000712202 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C10003339 (Delaware) | Primary |
| Provider Name | Valerie A Elener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801900816 PECOS PAC ID: 8224130919 Enrollment ID: I20101014001289 |
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