Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 201700781 | MO |
NPI | 1013447630 |
---|---|
Provider Name | Dr. Brian Thomas Sweeney |
First Address | Newark, DE 19711-2671 |
Second Address | Newark, DE 19711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2017 |
Last Update Date | 06/08/2017 |