Healthcare Provider Details

I. General information

NPI: 1720209703
Provider Name (Legal Business Name): BRIAN DELLIGATTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST EMERGENCY SERVICE ASSOCIATES
SALISBURY MD
21801-5422
US

IV. Provider business mailing address

100 EAST CARROLL ST EMERGENCY SERVICE ASSOCIATES
SALISBURY MD
21804
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-7742
  • Fax:
Mailing address:
  • Phone: 410-543-7742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0068437
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: