MEDICARE: DR. PAUL F DELL PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0810001153	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	092018	OTHER	VA	BLUECROSS/BLUESHIELD
2	240873	OTHER		MAMSI/MDIPA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104826635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL F DELL PHD

Provider Business Mailing Address
First Line	:	1709 COLLEY AVE
Second Line	:	SUITE 312
City	:	NORFOLK
State	:	VA
Zip	:	23517-1675
Country	:	US
Telephone Number	:	757-640-0400
Fax Number	:	757-640-0497

Provider Business Practice Location Address
First Line	:	1709 COLLEY AVE
Second Line	:	SUITE 312
City	:	NORFOLK
State	:	VA
Zip	:	23517-1675
Country	:	US
Telephone Number	:	757-640-0400
Fax Number	:	757-640-0497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	09/23/2008

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Directions to “ DR. PAUL F DELL PHD” Practice Location

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