Provider Demographics
NPI:1194853952
Name:DELPORT, ANTON GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:GRANT
Last Name:DELPORT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2202
Mailing Address - Country:US
Mailing Address - Phone:302-494-8359
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN-STANTON
Practice Address - Street 2:ROADROOM 2A00-CHRISTIANA HOSPITAL
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:302-733-1041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4421822085R0202X
DEC1-00099222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology