Healthcare Provider Details

I. General information

NPI: 1316086812
Provider Name (Legal Business Name): DELPHI OB GYN GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OPITZ BLVD
WOODBRIDGE VA
22191-3311
US

IV. Provider business mailing address

PO BOX 75635
BALTIMORE MD
21275-5635
US

V. Phone/Fax

Practice location:
  • Phone: 901-226-0200
  • Fax: 901-226-0215
Mailing address:
  • Phone: 330-470-3700
  • Fax: 330-497-7940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID L JOYCE
Title or Position: OWNER
Credential:
Phone: 866-885-5522