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Individual

KEVIN D BRISTOWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
424 SAVANNAH RD, LEWES, DE 19958
(302) 645-3296
(302) 645-3862
Mailing address
PO BOX 3012, WILMINGTON, DE 19804
(302) 224-5678
(302) 224-2848

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C10005371
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000882401
DE
05
000882401
DE
Enumeration date
01/10/2006
Last updated
04/28/2008
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