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Individual

DR. DELIA CHRISTINA MELTONTATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1415 NORTH BROAD STREET, SUITE 224, BROAD STREET HEALTH CENTER, PHILADELPHIA, PA 19122-3323
(215) 235-7944
(215) 235-3361
Mailing address
5619-25 VINE STREET, SPECTRUM HEALTH SERVICES, INC., PHILADELPHIA, PA 19139-1302
(215) 471-2761
(215) 471-2929

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD043306L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019487970002
PA
01
002769
FIRST PRIORITY HEALTH
PA
05
01948797
PA
01
1490297
HIGHMARK BLUE SHIELD
PA
01
232175463
AETNA
PA
01
96030-C241
GEISINGER
PA
Enumeration date
01/23/2006
Last updated
01/20/2011
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