Individual
DR. MIGUEL B DELMAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3215 MCCLURE BRIDGE RD, DULUTH, GA 30096
(678) 312-6200
(678) 312-6226
Mailing address
5403 OAK CREST LN, BUFORD, GA 30518-9029
(404) 722-9753
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
065651
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003114073F
—
GA
05
—
003114073G
—
GA
05
—
003114073H
—
GA
05
—
003114073I
—
GA
05
—
003114073J
—
GA
05
—
003114073K
—
GA
05
—
003114073L
—
GA
05
—
003114073M
—
GA
05
—
003114073N
—
GA
01
—
02378992
AMERIGROUP
GA
01
—
1022567
WELLCARE
GA
01
—
1489990
COVENTRY
GA
01
—
52515750
BCBS
GA
01
—
9672923
CIGNA
GA
01
—
9738749
AETNA
GA
Enumeration date
02/11/2009
Last updated
04/19/2023
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