Provider Demographics
NPI:1194723957
Name:DELNOSTRO, DAVID JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:DELNOSTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 MALL BLVD
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4797
Mailing Address - Country:US
Mailing Address - Phone:912-358-1515
Mailing Address - Fax:912-480-0505
Practice Address - Street 1:318 MALL BLVD
Practice Address - Street 2:SUITE 300B
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4797
Practice Address - Country:US
Practice Address - Phone:912-358-1515
Practice Address - Fax:912-480-0505
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG21671Medicaid
GA681678OtherBLUECROSS BLUESHIELD
GA010055976OtherRR MEDICARE
GA000229853CMedicaid
GA000229853CMedicaid
GA000229853CMedicaid