Provider Demographics
NPI:1023857919
Name:STEGALL, DELBERT C
Entity type:Individual
Prefix:
First Name:DELBERT
Middle Name:C
Last Name:STEGALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-1563
Mailing Address - Country:US
Mailing Address - Phone:419-202-9826
Mailing Address - Fax:
Practice Address - Street 1:616 E 7TH ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1563
Practice Address - Country:US
Practice Address - Phone:419-202-9826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide