Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4301406533 | MI |
NPI | 1033189915 |
---|---|
Provider Name | Dr. Ralph Ernest Delius |
First Address | West Bloomfield, MI 48322-3627 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 01/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0208291491 | BCBS OF MICHIGAN (01) | |
430214410 | (05) | MI |
E80127 | (02) |