Basic Information
| Provider Information | |||||||||
| NPI: | 1013988419 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PYNE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1602 NEWPORT GAP PIKE | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198086208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026335840 | ||||||||
| FaxNumber: | 3026335844 | ||||||||
| Practice Location | |||||||||
| Address1: | 17252 N VILLAGE MAIN BLVD | ||||||||
| Address2: | |||||||||
| City: | LEWES | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199586292 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026447020 | ||||||||
| FaxNumber: | 3026447021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 07/21/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111NX0800X | F1-0000572 | DE | Y | Chiropractic Providers | Chiropractor | Orthopedic |
ID Information
| ID | Type | State | Issuer | Description | 562364816 | 01 | DE | BCBS OF DE | OTHER |