Delisi, Stephen M
Delisi, Stephen M is an sole proprietor health care provider with primary practice located at 700 Raymond Ave Ste 130 , Saint Paul MN 55114-1778. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Delisi, Stephen M can be contacted via phone (612) 699-7778.Contact Information
Primary practice address
700 Raymond Ave Ste 130
Saint Paul MN 55114-1778
Phone: (612) 699-7778
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 48123 | Minnesota |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 46660 | Wisconsin |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 48123 | Minnesota |
Profile Details
| NPI number | 1528063765 |
|---|---|
| LBN Legal business name | Delisi, Stephen M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2005 |
| Last updated | May 30th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528063765 | NPPES |
| Wisconsin | MEDICAID | 34550800 |
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