MEDICARE: GWENDOLYN A DELANEY 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	208000000X	Pediatrics Physician	049380	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1720085012	OTHER	GA	NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720085012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWENDOLYN A DELANEY MD

Provider Business Mailing Address
First Line	:	4914 HIGHWAY 9 N
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-2921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 PEACHTREE PKWY STE 4260
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-7407
Country	:	US
Telephone Number	:	678-990-2501
Fax Number	:	678-990-2505

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	01/14/2020

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Directions to “ GWENDOLYN A DELANEY MD” Practice Location

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