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Individual

TIMOTHY A DELEHANTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3501 IROQUOIS TRL, MICHIGAN CITY, IN 46360-1013
(219) 879-4374
Mailing address
3501 IROQUOIS TRL, MICHIGAN CITY, IN 46360-1013
(219) 879-4364

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01028947A
IN
207V00000X
Obstetrics & Gynecology Physician
31793
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100326870
IN
Enumeration date
09/20/2005
Last updated
07/23/2012
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