Organization
FENWICK MEDICAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS NICHOLSON BORODULIA (PRACTICE OWNER)
(302) 581-0458
Entity
Organization
Contact information
Practice address
1400 COASTAL HWY, FENWICK ISLAND, DE 19944
(302) 581-0458
(302) 581-0460
Mailing address
12036 S PINEY POINT RD, BISHOPVILLE, MD 21813-1542
(410) 430-5154
(410) 352-5430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
C10001802
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG9614
RAILROAD MEDICARE
DE
Enumeration date
06/19/2006
Last updated
09/24/2025
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