Individual
RAVEN LIONEL DELOATCH
Active
Individual
RAVEN LIONEL DELOATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31478
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0454365
UNITED HEALTH CARE #
NC
01
—
110147756
RAILROAD MEDICARE #
NC
01
—
112536
ANTHEM SERVICES PROVIDER#
NC
01
—
28324
BLUE CROSS BLUE SHIELD #
NC
01
—
289354
MAMSI PROVIDER #
NC
01
—
31478
NC MEDICAL LICENSE #
NC
05
—
7928324
—
NC
01
—
D2792
MEDCOST LLC PROVIDER #
NC
Enumeration date
01/03/2006
Last updated
03/07/2023
Update your record
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