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General NPI Number Information
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NPI Number | 1467414466
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Entity Type | Individual
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Provider Name | RICARDO J DELGADO MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 1000 MEDICAL CENTER BLVD DEPARTMENT OF PATHOLOGY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7694
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Country | US
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Telephone | 678-442-4321
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1686
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-1686
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Country | US
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Telephone | 317-614-9863
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Fax | 706-232-0156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 36956
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License Number State | GA
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