Provider Demographics
NPI:1073739140
Name:DENNIS A DEBIAS M D P C
Entity Type:Organization
Organization Name:DENNIS A DEBIAS M D P C
Other - Org Name:DELPHI FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DEBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-287-6650
Mailing Address - Street 1:1000 GRAVEL PIKE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2364
Mailing Address - Country:US
Mailing Address - Phone:610-287-6650
Mailing Address - Fax:610-287-6652
Practice Address - Street 1:1000 GRAVEL PIKE
Practice Address - Street 2:SUITE 400
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-2364
Practice Address - Country:US
Practice Address - Phone:610-287-6650
Practice Address - Fax:610-287-6652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039666E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001427743OtherBLUE SHIELD
PA0015412750006Medicaid
PA2114611000OtherPERSONAL CHOICE
PA2114611001OtherKEYSTONE HEALTHPLAN EAST
PA000139129OtherAETNA USHC
PA2114611001OtherKEYSTONE HEALTHPLAN EAST