Individual
KHORTNAL DELVECCHIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6701 W OUTER DR # M501, DETROIT, MI 48235
(313) 966-1941
Mailing address
2915 JOHN R ST, APT. 503, DETROIT, MI 48201-2908
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS18070
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/05/2014
Last updated
09/24/2021
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