Individual
MICHAEL THOMAS DELVECCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-5437
(215) 707-5180
Mailing address
PO BOX 827783, PHILADELPHIA, PA 19185-7783
(215) 707-5437
(215) 707-5180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD043982L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012435220009
—
PA
Enumeration date
10/12/2005
Last updated
04/06/2010
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