Basic Information
| Provider Information | |||||||||
| NPI: | 1396799961 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELRIO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 359 | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477030359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124851220 | ||||||||
| FaxNumber: | 8124858544 | ||||||||
| Practice Location | |||||||||
| Address1: | 3700 WASHINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477140541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124854335 | ||||||||
| FaxNumber: | 8124857563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 07/21/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 01034792 | IN | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100180890E | 05 | IN | MEDICAID | 100247500 | 05 | IN | MEDICAID | 000000108948 | 01 | IN | ANTHEM PROVIDER # | OTHER |