Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | C1-0000918 | DE |
N | 2084N0400X | Neurologist | C1-0000918 | DE |
N | 2084N0402X | Child Neurologist | C10000918 | DE |
NPI | 1124070404 |
---|---|
Provider Name | Sidney Charles Bean |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 27/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
169201 | (05) | DE |
D73624 | (02) |