Provider Demographics
NPI:1376986646
Name:DELTA FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:DELTA FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBEILY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-500-0374
Mailing Address - Street 1:15215 SHADY GROVE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3235
Mailing Address - Country:US
Mailing Address - Phone:301-500-0374
Mailing Address - Fax:301-540-6166
Practice Address - Street 1:15215 SHADY GROVE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3235
Practice Address - Country:US
Practice Address - Phone:301-500-0374
Practice Address - Fax:301-540-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty