Provider Demographics
NPI:1275512212
Name:EGGERT, DELMER (MD)
Entity Type:Individual
Prefix:
First Name:DELMER
Middle Name:
Last Name:EGGERT
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 1:22 BELA VISTA CT
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4135
Mailing Address - Country:US
Mailing Address - Phone:507-345-6662
Mailing Address - Fax:
Practice Address - Street 1:22 BELA VISTA CT
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4135
Practice Address - Country:US
Practice Address - Phone:507-345-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA163812084P0800X
MN193852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0572156Medicaid
MNHP36647OtherHEALTH PARTNERS
MN379S2EGOtherBCBS
41084933956001F002OtherCHAMPUS
P00106204OtherRR MEDICARE
MN1650080OtherAMERICAS PPO
MNNA2951027769OtherPREFERRED ONE
MN120008OtherUCARE
MN39676100Medicaid
MN1650080OtherAMERICAS PPO