Provider Demographics
NPI:1588653810
Name:BRICKHOUSE, NEAL ANGELO (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:ANGELO
Last Name:BRICKHOUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10925
Mailing Address - Street 2:BAY ANESTHESIA ASSOCIATES LLC
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19850-0925
Mailing Address - Country:US
Mailing Address - Phone:302-674-4700
Mailing Address - Fax:
Practice Address - Street 1:640 S STATE ST
Practice Address - Street 2:BAY ANESTHESIA ASSOCIATES LLC
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3530
Practice Address - Country:US
Practice Address - Phone:302-674-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0009591207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC1-0009591OtherPROFESSIONAL LICENSE-PHYSICIAN MD
DEDR-0007828OtherCDS CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE
DEDR-0007828OtherCDS CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE