Individual
SHANIQUE BROWN KILGALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 ROCKLAND RD, WILMINGTON, DE 19803-3607
(302) 651-4200
(302) 651-4945
Mailing address
PO BOX 191, ROCKLAND, DE 19732-0191
(302) 651-4200
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C1-0013749
DE
207L00000X
Anesthesiology Physician
MD445846
PA
207L00000X
Anesthesiology Physician
MT192730
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331247EJL
MEDICARE PTAN
PA
Enumeration date
06/25/2008
Last updated
12/21/2020
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