| 302 Family Medicine, Llc | |
|
306 Polk Ave Milford DE 19963-1818 | |
| (302) 300-3514 | |
| Not Available |
| Full Name | 302 Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 306 Polk Ave, Milford, Delaware |
| Authorized Official Name and Position | Michelle Bretzius (PHYSICIAN) |
| Authorized Official Contact | 7176442648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 302 Family Medicine, Llc 322 Robbins Rd Frederica DE 19946-1955 Ph: (717) 644-2648 | 302 Family Medicine, Llc 306 Polk Ave Milford DE 19963-1818 Ph: (302) 300-3514 |
| NPI Number | 1871220079 |
|---|---|
| Provider Enumeration Date | 08/07/2022 |
| Last Update Date | 08/07/2022 |
| Medicare PECOS PAC ID | 6901281112 |
|---|---|
| Medicare Enrollment ID | O20220923000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871220079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michelle L Bretzius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770878092 PECOS PAC ID: 2264658293 Enrollment ID: I20140728000544 |
| Provider Name | Lisa Marie Beavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700373289 PECOS PAC ID: 6608122700 Enrollment ID: I20220704000205 |
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