Basic Information
| Provider Information | |||||||||
| NPI: | 1316086812 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DELPHI OB GYN GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 75635 | ||||||||
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| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212755635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304703700 | ||||||||
| FaxNumber: | 3304977940 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 OPITZ BLVD | ||||||||
| Address2: | |||||||||
| City: | WOODBRIDGE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221913311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012260200 | ||||||||
| FaxNumber: | 9012260215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | JOYCE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8668855522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.