Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | F1-0000688 | DE |
NPI | 1427229426 |
---|---|
Provider Name | Dr. Philip Bruce Demond |
First Address | Newark, DE 19713-3217 |
Second Address | Newark, DE 19711-5539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2008 |
Last Update Date | 18/03/2008 |