Healthcare Provider Details

I. General information

NPI: 1639616337
Provider Name (Legal Business Name): ROBERT DELZER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N DUPONT HWY APT. H304
DOVER DE
19901-7811
US

IV. Provider business mailing address

1700 N DUPONT HWY APT. H304
DOVER DE
19901-7811
US

V. Phone/Fax

Practice location:
  • Phone: 443-567-2330
  • Fax:
Mailing address:
  • Phone: 443-567-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberL1-0049820
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: