| Brandywine Hundred Family Medicine, Llc | |
|
3521 Silverside Rd Suite 2f1 Wilmington DE 19810-4900 | |
| (302) 478-5650 | |
| (302) 477-0455 |
| Full Name | Brandywine Hundred Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3521 Silverside Rd, Wilmington, Delaware |
| Authorized Official Name and Position | Judith C Wollman (PARTNER) |
| Authorized Official Contact | 3024785650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandywine Hundred Family Medicine, Llc 3521 Silverside Rd Suite 2f1 Wilmington DE 19810-4900 Ph: (302) 478-5650 | Brandywine Hundred Family Medicine, Llc 3521 Silverside Rd Suite 2f1 Wilmington DE 19810-4900 Ph: (302) 478-5650 |
| NPI Number | 1235186081 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0446256143 |
|---|---|
| Medicare Enrollment ID | O20061019000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235186081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 006525282724 (Delaware) | Primary |
| Provider Name | Matthew M O Brien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417996935 PECOS PAC ID: 5496641292 Enrollment ID: I20040227000185 |
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