Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 042809 | GA |
N | 111NI0900X | Internist | 042809 | GA |
N | 207R00000X | Internist | 17723 | AL |
N | 111NI0900X | Internist | 17723 | AL |
N | 207R00000X | Internist | 28033 | TN |
N | 111NI0900X | Internist | 28033 | TN |
Y | 207R00000X | Internist | 51551 | CO |
Y | 111NI0900X | Internist | 51551 | CO |
N | 207RA0401X | Internist - Addiction Medicine | 28033 | TN |
N | 207RA0401X | Internist - Addiction Medicine | 51551 | CO |
N | 207RG0300X | Geriatric Medicine | 28033 | TN |
N | 207RG0300X | Geriatric Medicine | 51551 | CO |
N | 207RH0002X | Hospice and Palliative Medicine | 28033 | TN |
N | 207RH0002X | Hospice and Palliative Medicine | 51551 | CO |
NPI | 1770682874 |
---|---|
Provider Name | Oscar David Dellinger III |
First Address | Honolulu, HI 96817-1127 |
Second Address | Honolulu, HI 96817-1127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 16/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00828176A | (05) | GA |
F80030 | (02) |