Organization
BRANDYWINE IMAGING ENTERPRISES LLC
Active
Parent organization
DIA PRACTICE ENTERPRISES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIA PRACTICE ENTERPRISES LLC
Authorized official
VICTORIA L PEACOCK MS, MS (PROJECT MANAGER)
(302) 993-2330
Entity
Organization
Contact information
Practice address
3206 CONCORD PIKE, WILMINGTON, DE 19803-5015
(302) 654-5300
(302) 654-1967
Mailing address
1601 MILLTOWN RD, SUITE 13, WILMINGTON, DE 19808-4027
(302) 993-2330
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000137202
—
DE
Enumeration date
04/27/2006
Last updated
02/23/2015
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