Provider Demographics
NPI:1205397684
Name:DELERME, FRITZ
Entity Type:Individual
Prefix:
First Name:FRITZ
Middle Name:
Last Name:DELERME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HILL PEAK CT
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-9510
Mailing Address - Country:US
Mailing Address - Phone:843-473-4569
Mailing Address - Fax:
Practice Address - Street 1:3715 ARGENT BLVD
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-3101
Practice Address - Country:US
Practice Address - Phone:843-473-4569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)