Provider Demographics
NPI:1376511659
Name:DELGADO, GABRIEL ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:ANGEL
Last Name:DELGADO
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-264-3500
Mailing Address - Fax:704-417-4989
Practice Address - Street 1:1718 E 4TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3261
Practice Address - Country:US
Practice Address - Phone:704-343-9800
Practice Address - Fax:704-347-2011
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00412207RC0000X, 207RI0011X
WAMD00042334208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
9026DEOtherREGENCE BLUE SHIELD RIDER
WA8358343Medicaid
P00079219OtherRAILROAD MEDICARE
WA8358343Medicaid
AB39962Medicare ID - Type Unspecified