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Individual

P. VANCE PREWITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
402 E 4TH ST, LAUREL, DE 19956-1552
(302) 875-4411
Mailing address
402 E 4TH ST, LAUREL, DE 19956-1552
(302) 875-4411

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C10002606
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811051816
DE
Enumeration date
12/21/2006
Last updated
05/22/2008
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