Basic Information
| Provider Information | |||||||||
| NPI: | 1639253453 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DELMAR DEHART MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3061 CHRISTY WAY | ||||||||
| Address2: | PRO MED BILLING | ||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486032267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897912455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3615 CHRISTY WAY E | ||||||||
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| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486032295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898604735 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DEHART | ||||||||
| AuthorizedOfficialFirstName: | DELMAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9898604735 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 4704138338 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.