Individual
DR. MICHAEL V. DELOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 NW KINGS BLVD, CORVALLIS, OR 97330-2521
(541) 321-8552
Mailing address
1220 NW KINGS BLVD, CORVALLIS, OR 97330-2521
(541) 321-8552
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
G59726
CA
2084P0800X
Psychiatry Physician
MD11748
OR
2084P0800X
Psychiatry Physician
Primary
MD175003
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500708139
—
OR
Enumeration date
07/13/2005
Last updated
05/28/2021
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