Provider Demographics
NPI:1356424691
Name:DELO, MARJORIE J (MD)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:J
Last Name:DELO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2595 DEVELOPMENT DR STE 140
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4267
Mailing Address - Country:US
Mailing Address - Phone:920-632-7248
Mailing Address - Fax:920-632-4249
Practice Address - Street 1:2595 DEVELOPMENT DR STE 140
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4267
Practice Address - Country:US
Practice Address - Phone:920-632-7248
Practice Address - Fax:920-632-4249
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-12-09
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Provider Licenses
StateLicense IDTaxonomies
WI47287207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine