Individual
DR. CESAR MEDALLA DELIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 ALCOVY STREET, SUITE 10, MONROE, GA 30655
(770) 267-2790
(770) 207-0652
Mailing address
2151B W SPRING ST, STE 210, MONROE, GA 30655-3115
(770) 267-2790
(770) 207-0652
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
028396
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000324244D
—
GA
01
—
52238010
BLUE CROSS BLUE SHIELD
GA
Enumeration date
05/10/2007
Last updated
10/11/2016
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