Healthcare Provider Details

I. General information

NPI: 1871542209
Provider Name (Legal Business Name): DELPHI HEALTHCARE PARTNERS OF MARYLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 CHARLES ST
LA PLATA MD
20646-5930
US

IV. Provider business mailing address

PO BOX 15268
ASHEVILLE NC
28813-0268
US

V. Phone/Fax

Practice location:
  • Phone: 301-609-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID JOYCE
Title or Position: PRESIDENT
Credential:
Phone: 866-885-5522