Provider Demographics
NPI:1114083490
Name:DARLING, BRYAN W (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:W
Last Name:DARLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HADDONFIELD BERLIN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3520
Mailing Address - Country:US
Mailing Address - Phone:856-782-2212
Mailing Address - Fax:856-782-2266
Practice Address - Street 1:1000 HADDONFIELD BERLIN RD STE 210
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3520
Practice Address - Country:US
Practice Address - Phone:856-782-2212
Practice Address - Fax:856-782-2266
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS143362080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1114083490Medicaid
MS00119709Medicaid
MI1114083490Medicaid
AL177488Medicaid
NJ0754064Medicaid
GA003179263AMedicaid
MO1114083490Medicaid
TN1510195Medicaid
AR175309001Medicaid
KY7100464610Medicaid