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Individual

DR. WILLIAM D. TYNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
A.I. DUPONT HOSPITAL FOR CHILDREN, 1600 ROCKLAND ROAD, WILMINGTON, DE 19803-3607
(302) 651-4000
(302) 651-4945
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 444-9075
(302) 444-9200

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
B10000589
DE
2080P0006X
Developmental - Behavioral Pediatrics Physician
B10000589
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001705190
PA
05
6023215
MD
05
83366608
NJ
Enumeration date
09/29/2006
Last updated
09/13/2012
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