Provider Demographics
NPI:1093783748
Name:TERMEULEN, DEBORAH C (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:TERMEULEN
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 1:736 CAMBRIDGE ST
Mailing Address - Street 2:DEPT RADIOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2907
Mailing Address - Country:US
Mailing Address - Phone:617-789-2740
Mailing Address - Fax:617-779-6343
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:DEPT RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-2740
Practice Address - Fax:617-779-6343
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA553692085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ05354Medicare ID - Type Unspecified
MAA58359Medicare UPIN