Basic Information
| Provider Information | |||||||||
| NPI: | 1114083490 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DARLING | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 HADDONFIELD BERLIN RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080433520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567822212 | ||||||||
| FaxNumber: | 8567822266 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 HADDONFIELD BERLIN RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080433520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567822212 | ||||||||
| FaxNumber: | 8567822266 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2006 | ||||||||
| LastUpdateDate: | 06/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 14336 | MS | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1114083490 | 05 | MS | MEDICAID | 00119709 | 05 | MS | MEDICAID | 1114083490 | 05 | MI | MEDICAID | 177488 | 05 | AL | MEDICAID | 0754064 | 05 | NJ | MEDICAID | 003179263A | 05 | GA | MEDICAID | 1114083490 | 05 | MO | MEDICAID | 1510195 | 05 | TN | MEDICAID | 175309001 | 05 | AR | MEDICAID | 7100464610 | 05 | KY | MEDICAID |