MEDICARE: PAUL V DELAMATER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0205X	Pediatric Endocrinology Physician	35031765	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4044692	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1104823210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL V DELAMATER MD

Provider Business Mailing Address
First Line	:	2100 W CENTRAL AVE
Second Line	:	SUITE 100
City	:	TOLEDO
State	:	OH
Zip	:	43606-3834
Country	:	US
Telephone Number	:	419-537-5111
Fax Number	:	419-537-5131

Provider Business Practice Location Address
First Line	:	2100 W CENTRAL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3834
Country	:	US
Telephone Number	:	419-537-5111
Fax Number	:	419-537-5131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/24/2014

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