Provider Demographics
NPI:1972624260
Name:A. LEE DELLON, MD, PA
Entity Type:Organization
Organization Name:A. LEE DELLON, MD, PA
Other - Org Name:DELLON INST.FOR PERIPHERAL NERVE SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-337-5400
Mailing Address - Street 1:3333 N CALVERT ST
Mailing Address - Street 2:SUITE 370
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2867
Mailing Address - Country:US
Mailing Address - Phone:410-366-9825
Mailing Address - Fax:410-366-9826
Practice Address - Street 1:8601 LA SALLE RD STE 104
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2005
Practice Address - Country:US
Practice Address - Phone:410-337-5400
Practice Address - Fax:410-337-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019722208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKCC3INOtherBLUE SHIELD GROUP NUMBER
MDKCC3INOtherBLUE SHIELD GROUP NUMBER