Provider Demographics
NPI:1063461689
Name:WILBUR, DEBORAH W (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:W
Last Name:WILBUR
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 1:701 10TH ST SE
Mailing Address - Street 2:HPCC 3RD FLOOR
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1251
Mailing Address - Country:US
Mailing Address - Phone:319-363-8303
Mailing Address - Fax:319-364-4659
Practice Address - Street 1:701 10TH ST SE
Practice Address - Street 2:HPCC 3RD FLOOR
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1251
Practice Address - Country:US
Practice Address - Phone:319-363-8303
Practice Address - Fax:319-364-4659
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34639207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA11429OtherWELLMARK BC/BS
IA1264549Medicaid
IAP00321055OtherRAILROAD MEDICARE
IA11429OtherWELLMARK BC/BS
I17606Medicare PIN