Healthcare Provider Details

I. General information

NPI: 1891481305
Provider Name (Legal Business Name): DELIA GEORGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SIGMAN RD NE STE 230
CONYERS GA
30012-3819
US

IV. Provider business mailing address

760 BROADWAY
BROOKLYN NY
11206-5317
US

V. Phone/Fax

Practice location:
  • Phone: 678-609-4912
  • Fax:
Mailing address:
  • Phone: 718-963-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number112600
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: