Dr Miguel B Delmazo, MD | |
3215 Mcclure Bridge Rd, Duluth, GA 30096 | |
(678) 312-6200 | |
(678) 312-6226 |
Full Name | Dr Miguel B Delmazo |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 3215 Mcclure Bridge Rd, Duluth, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598904740 | NPI | - | NPPES |
003114073F | Medicaid | GA | |
003114073L | Medicaid | GA | |
9738749 | Other | GA | AETNA |
52515750 | Other | GA | BCBS |
003114073N | Medicaid | GA | |
1489990 | Other | GA | COVENTRY |
003114073H | Medicaid | GA | |
003114073K | Medicaid | GA | |
02378992 | Other | GA | AMERIGROUP |
003114073I | Medicaid | GA | |
003114073M | Medicaid | GA | |
003114073G | Medicaid | GA | |
1022567 | Other | GA | WELLCARE |
9672923 | Other | GA | CIGNA |
003114073J | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 065651 (Georgia) | Primary |
Entity Name | The Longstreet Clinic, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326019977 PECOS PAC ID: 2668465733 Enrollment ID: O20040405001521 |
Mailing Address | Practice Location Address |
---|---|
Dr Miguel B Delmazo, MD 5403 Oak Crest Ln, Buford, GA 30518-9029 Ph: (404) 722-9753 | Dr Miguel B Delmazo, MD 3215 Mcclure Bridge Rd, Duluth, GA 30096 Ph: (678) 312-6200 |
Delquis Rafael Mendoza Jr., M.D. Surgery Medicare: Medicare Enrolled Practice Location: 3970 Rogers Bridge Rd, Duluth, GA 30097 Phone: 404-265-1579 | |
Glenn M Hall Jr., M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3855 Pleasant Hill Rd Ste 470, Duluth, GA 30096 Phone: 678-312-7280 | |
Dr. Robert C Fritz, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3655 Howell Ferry Rd Ste 200, Duluth, GA 30096 Phone: 770-476-7047 Fax: 408-335-4730 | |
Mr. Hernan Dario Urrego, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3650 Steve Reynolds Blvd, Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 Phone: 404-881-8020 | |
Miss Erjia Bao, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 11205 Abbotts Walk Dr, Duluth, GA 30097 Phone: 770-365-7337 | |
Micheal A Hall, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3855 Pleasant Hill Rd Ste 470, Duluth, GA 30096 Phone: 678-312-7280 Fax: 678-312-7299 | |
Erica N Proctor, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3855 Pleasant Hill Rd Ste 280, Duluth, GA 30096 Phone: 678-312-7490 Fax: 678-312-7499 |