Basic Information
| Provider Information | |||||||||
| NPI: | 1184650152 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELGADO | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55310 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057319701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 19TH STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059344011 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 7184 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 000038318 | 05 | AL | MEDICAID | 121708 | 05 | AL | MEDICAID | 01279851 | 05 | MS | MEDICAID | 051110663 | 01 | AL | BCBS | OTHER | 051594050 | 01 | AL | BCBS | OTHER | 051594051 | 01 | AL | BCBS | OTHER | 510-05048 | 01 | AL | BC BS OF ALABAMA | OTHER | 051039961 | 01 | AL | BLUECROSS BLUESHIELD AL | OTHER | P00408514 | 01 | AL | RAILROAD MEDICARE | OTHER | P00799671 | 01 | AL | RAILROAD MEDICARE | OTHER | 009943009 | 05 | AL | MEDICAID | 051594048 | 01 | AL | BCBS | OTHER | 105715 | 05 | AL | MEDICAID | 105717 | 05 | AL | MEDICAID | 105722 | 05 | AL | MEDICAID |