Healthcare Provider Details

I. General information

NPI: 1881804755
Provider Name (Legal Business Name): EMILY M DALIGGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 JEFFERSON DR
ZUMBROTA MN
55992-1180
US

IV. Provider business mailing address

1350 JEFFERSON DR
ZUMBROTA MN
55992-1180
US

V. Phone/Fax

Practice location:
  • Phone: 507-732-7314
  • Fax: 507-732-7610
Mailing address:
  • Phone: 507-732-7314
  • Fax: 507-732-7610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number52188
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number52188
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: