Provider Demographics
NPI:1184187825
Name:DELGADO, RAVEN V (MD)
Entity Type:Individual
Prefix:
First Name:RAVEN
Middle Name:V
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 MEDICAL PARK DR STE 207
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4778
Mailing Address - Country:US
Mailing Address - Phone:843-383-7350
Mailing Address - Fax:843-332-9229
Practice Address - Street 1:701 MEDICAL PARK DR STE 207
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4778
Practice Address - Country:US
Practice Address - Phone:843-383-7350
Practice Address - Fax:843-332-9229
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCMMD.88525.MD208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics