Healthcare Provider Details

I. General information

NPI: 1134689490
Provider Name (Legal Business Name): REGINA DELBAUGH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MARSHALL ST
RICHMOND VA
23298-5023
US

IV. Provider business mailing address

ONE MEDICAL CENTER DRIVE DHMC DEPARTMENT OF PATHOLOGY
LEBANON NH
03756-0001
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-0183
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number0102208405
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0102208405
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: