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Organization

DELBELLO, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK W DELBELLO MD (PRESIDENT)
(260) 482-1681
Entity
Organization

Contact information

Practice address
3124 E STATE BLVD, SUITE 3F, FORT WAYNE, IN 46805-4763
(260) 482-1681
(260) 482-1857
Mailing address
PO BOX 715375, COLUMBUS, OH 43271-5375
(260) 969-1950
(260) 918-2137

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01037213
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000527354
ANTHEM
IN
01
0462448
CIGNA
05
100323980
IN
01
110175714
RAILROAD MEDICARE
IN
01
1220
PHYSICIANS HEALTH PLAN
01
4134142
AETNA
Enumeration date
02/07/2007
Last updated
06/29/2011
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