MEDICARE: MRS. PAULA R DELK M.S., C.G.C.

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	170300000X	Genetic Counselor (M.S.)	74000010A	IN
2	170300000X	Genetic Counselor (M.S.)

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

General Provider Information

NPI Number	:	1538143771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA R DELK M.S., C.G.C.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 W WALNUT ST
Second Line	:	IB-130
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5181
Country	:	US
Telephone Number	:	317-278-8837
Fax Number	:	317-274-2387

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	07/05/2022

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