Provider Demographics
NPI:1124020094
Name:BRITCHKOW, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BRITCHKOW
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 1:111 CONTINENTAL DR
Mailing Address - Street 2:SUITE 406
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4306
Mailing Address - Country:US
Mailing Address - Phone:302-368-2630
Mailing Address - Fax:302-368-1271
Practice Address - Street 1:111 CONTINENTAL DR
Practice Address - Street 2:SUITE 406
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4306
Practice Address - Country:US
Practice Address - Phone:302-368-2630
Practice Address - Fax:302-368-1271
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050667L207RC0000X
DEC10008192207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016169200004Medicare ID - Type Unspecified
643378GT6Medicare UPIN
DEG02723I04Medicare PIN
G09183Medicare UPIN