MEDICARE: DR. MATTHEW J DELFINO JR. MD, MBA

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	207Q00000X	Family Medicine Physician	35524	SC
2	207Q00000X	Family Medicine Physician	205063	LA

General Provider Information

NPI Number	:	1508182536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW J DELFINO JR. MD, MBA

Provider Business Mailing Address
First Line	:	220 IRBY ST
Second Line	:
City	:	WOODRUFF
State	:	SC
Zip	:	29388-1618
Country	:	US
Telephone Number	:	864-670-9415
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 IRBY ST
Second Line	:
City	:	WOODRUFF
State	:	SC
Zip	:	29388-1618
Country	:	US
Telephone Number	:	864-670-9415
Fax Number	:

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

Provider Enumeration Date	:	04/15/2010
Last Update Date	:	02/14/2014

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