Provider Demographics
NPI:1285745190
Name:DELMAN, ERIC BENJAMIN (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BENJAMIN
Last Name:DELMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MT CARMEL WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-7587
Mailing Address - Country:US
Mailing Address - Phone:620-235-7605
Mailing Address - Fax:
Practice Address - Street 1:1 MED CENTER CIR
Practice Address - Street 2:SUITE A
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6740
Practice Address - Country:US
Practice Address - Phone:620-235-7605
Practice Address - Fax:620-235-7609
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8917208600000X
KS05-38435208600000X
OK5911208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX89170Medicaid
20-3799368OtherFEDERAL TAX ID
CA20A8917OtherSTATE MEDICAL LISCENCE
20-3799368OtherFEDERAL TAX ID
I18709Medicare UPIN