Provider Demographics
NPI:1225039449
Name:DELSON, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-2114
Mailing Address - Country:US
Mailing Address - Phone:413-788-4464
Mailing Address - Fax:413-788-7133
Practice Address - Street 1:911 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-2114
Practice Address - Country:US
Practice Address - Phone:413-788-4464
Practice Address - Fax:413-788-7133
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU62020Medicare UPIN
MAY49016Medicare ID - Type Unspecified