Provider Demographics
NPI:1013988419
Name:PYNE, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PYNE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6208
Mailing Address - Country:US
Mailing Address - Phone:302-633-5840
Mailing Address - Fax:302-633-5844
Practice Address - Street 1:17252 N VILLAGE MAIN BLVD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6292
Practice Address - Country:US
Practice Address - Phone:302-644-7020
Practice Address - Fax:302-644-7021
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000572111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE562364816OtherBCBS OF DE
DE562364816OtherBCBS OF DE
DEG01270Medicare ID - Type Unspecified