Provider Demographics
NPI:1770601106
Name:DELGADO, NELSON STEPHEN (OD)
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:STEPHEN
Last Name:DELGADO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:N. STEPHEN
Other - Middle Name:
Other - Last Name:DELGADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:10300 LITTLE PATUXENT PKWY
Mailing Address - Street 2:SUITE 1005-B
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3341
Mailing Address - Country:US
Mailing Address - Phone:410-740-9952
Mailing Address - Fax:410-740-9731
Practice Address - Street 1:10300 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 1005-B
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3341
Practice Address - Country:US
Practice Address - Phone:410-740-9952
Practice Address - Fax:410-740-9731
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD1273152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD106M998EMedicare ID - Type Unspecified
MDU56058Medicare UPIN