Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 2007-00475 | NC |
NPI | 1114128618 |
---|---|
Provider Name | Daniel Lee Delo |
First Address | Wilmington, NC 28401-6442 |
Second Address | Wilmington, NC 28401-6442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 11/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Z99982 | (02) | PA |