Provider Demographics
NPI:1144200585
Name:BILLMIRE, DEBORAH F (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:F
Last Name:BILLMIRE
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 1:705 RILEY HOSPITAL DR
Mailing Address - Street 2:STE 2500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5109
Mailing Address - Country:US
Mailing Address - Phone:317-274-4681
Mailing Address - Fax:317-274-4491
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:STE 2500
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-274-4681
Practice Address - Fax:317-274-4491
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053289A2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200285230Medicaid
IN185720AMedicare ID - Type Unspecified
IN200285230Medicaid