Provider Demographics
NPI:1013951243
Name:ROBERT A DELP MD PC
Entity Type:Organization
Organization Name:ROBERT A DELP MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-280-1414
Mailing Address - Street 1:626 CROOKS RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1310
Mailing Address - Country:US
Mailing Address - Phone:248-280-1414
Mailing Address - Fax:248-435-7557
Practice Address - Street 1:626 CROOKS RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1310
Practice Address - Country:US
Practice Address - Phone:248-280-1414
Practice Address - Fax:248-435-7557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036402207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4415926OtherAETNA
MIA76343OtherHAP
MI1606300881OtherBCBC BCN
MI116833OtherCARE CHOICES
MIA76343Medicare UPIN
MIA76343OtherHAP