Provider Demographics
NPI:1588760128
Name:DELGADO, MELISSA A (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 BOONE BLVD STE 710
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8100 BOONE BLVD STE 710
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2683
Practice Address - Country:US
Practice Address - Phone:703-448-6070
Practice Address - Fax:703-448-9292
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236981207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010328381Medicaid
VA010328381Medicaid
VA011358B65Medicare PIN