Delton Wade De Vose in Martinez - Addiction (substance Use Disorder)
Delton Wade De Vose - NPI 1194860759
Delton Wade De Vose is a Addiction (substance Use Disorder) in Martinez, Georgia. Delton Wade De Vose practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Delton Wade De Vose is 1194860759. The last update date is 2020-09-16.
Delton Wade De Vose's current location address is 4210 Columbia Rd Ste 11b, Martinez, Georgia. You can contact this provider via phone number 9199375486 and fax number 8884452452. The mailing address for Delton Wade De Vose is 4210 Columbia Rd Ste 11b, Martinez, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Delton Wade De Vose |
|---|---|
| Address | 4210 Columbia Rd Ste 11b, Martinez, Georgia |
| Phone Number | 9199375486 |
| Fax Number | 8884452452 |
| Sole Proprietor | Y |
| Credentials | PHD, LPCS, |
NPI Number Detail
| NPI Number | 1194860759 |
|---|---|
| Provider Enumeration Date | 2007-02-21 |
| Last Updated Date | 2020-09-16 |
Provider Mailing Address Detail
| Address | 4210 Columbia Rd Ste 11b |
|---|---|
| City | Martinez |
| State | Georgia (GA) |
| Post Code | 309070443 |
| Phone Number | 9199375486 |
| Fax Number | 8884452452 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 1658 |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3404922 | BCBS | ||
| 6103058 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Delton Wade De Vose by the Centers for Medicare & Medicaid Services?
The Delton Wade De Vose has been assigned the NPI (National Provider Identifier) 1194860759 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Delton Wade De Vose is located?
The Delton Wade De Vose is situated at the following address: 4210 Columbia Rd Ste 11B, Martinez, GA, 309070443.
What is Delton Wade De Vose's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Delton Wade De Vose is Addiction (substance Use Disorder), and the taxonomy code that classifies this field of practice is 101Ya0400X.
When did the Delton Wade De Vose receive its 1194860759?
The Delton Wade De Vose was issued its 1194860759 on 2007-02-21, which is the date when the organization was assigned this unique identifier.
As of what date was the information regarding Delton Wade De Vose, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Delton Wade De Vose, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-09-16.
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