Provider Demographics
NPI:1003949173
Name:SOLOMON, DEBORAH LEE (RD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:LIMA MEMORIAL HEALTH SYSTEM
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-226-5032
Mailing Address - Fax:419-998-4447
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:LIMA MEMORIAL HEALTH SYSTEM
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-226-5032
Practice Address - Fax:419-998-4447
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1721133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSOMT71451LI3600091Medicare ID - Type Unspecified