Individual
STEPHEN M DELISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 RAYMOND AVE STE 130, SAINT PAUL, MN 55114-1778
(612) 699-7778
Mailing address
700 RAYMOND AVE STE 130, SAINT PAUL, MN 55114-1778
(612) 699-7778
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
48123
MN
2084P0800X
Psychiatry Physician
46660
WI
2084P0800X
Psychiatry Physician
Primary
48123
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34550800
—
WI
Enumeration date
06/15/2005
Last updated
05/30/2023
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