MEDICARE: DR. KATHLEEN MARIE DELNAY M.D.

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	208800000X	Urology Physician	01052431A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	264180W	OTHER	IN	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000086166	OTHER		ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811992803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN MARIE DELNAY M.D.

Provider Business Mailing Address
First Line	:	211 N EDDY ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-3096
Country	:	US
Telephone Number	:	574-234-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 N EDDY ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-3096
Country	:	US
Telephone Number	:	574-234-4100
Fax Number	:	574-282-1739

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/01/2024

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