Provider Demographics
NPI:1003843012
Name:DAVIS-MERRITT, DEBORAH K (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:DAVIS-MERRITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:K
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2420 W 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5301
Mailing Address - Country:US
Mailing Address - Phone:303-318-2250
Mailing Address - Fax:303-318-2252
Practice Address - Street 1:1960 OGDEN ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3670
Practice Address - Country:US
Practice Address - Phone:303-318-1510
Practice Address - Fax:303-318-2481
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24921208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00190583OtherMEDICARE RAILROAD
CO01249218Medicaid
F15643Medicare UPIN
CO01249218Medicaid