Provider Demographics
NPI:1851340921
Name:DELIA, STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:DELIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 TREMONT ST
Mailing Address - Street 2:STE. 9
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5310
Mailing Address - Country:US
Mailing Address - Phone:781-934-1599
Mailing Address - Fax:781-934-6261
Practice Address - Street 1:20 TREMONT ST
Practice Address - Street 2:BLDG. 3
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5310
Practice Address - Country:US
Practice Address - Phone:781-934-1599
Practice Address - Fax:781-934-6261
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA78754208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA21237OtherHARVARD PILGRIM HEALTHCAR
MDB20354701OtherCIGNA
MD078754OtherTUFTS HEALTHCARE
MAJ14413OtherBLUE CROSS BLUE SHIELD OF
MA471293OtherAETNA
MA21237OtherHARVARD PILGRIM HEALTHCAR
MAF73531Medicare UPIN