Individual
RAVEN LIONEL DELOATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9425 NC HIGHWAY 305, JACKSON, NC 27845-9679
(252) 534-1661
(252) 534-2841
Mailing address
PO BOX 640, ROANOKE RAPIDS, NC 27870-0640
(252) 536-5791
(252) 536-5444
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
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us