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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528063765 NPPES
Wisconsin MEDICAID 34550800

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