Healthcare Provider Details

I. General information

NPI: 1295776383
Provider Name (Legal Business Name): JEFFREY S DELO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST CANCER CENTER 3RD FLOOR
ANDERSON SC
29621-1580
US

IV. Provider business mailing address

PO BOX 100174
COLUMBIA SC
29202-3174
US

V. Phone/Fax

Practice location:
  • Phone: 864-225-5131
  • Fax: 864-512-4585
Mailing address:
  • Phone: 864-225-5131
  • Fax: 864-512-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD060602L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25910
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number40335
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: