Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | F1-0000572 | DE |
NPI | 1013988419 |
---|---|
Provider Name | David Pyne |
First Address | Wilmington, DE 19808-6208 |
Second Address | Lewes, DE 19958-6292 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
562364816 | BCBS OF DE (01) | DE |
U96138 | (02) | DE |