Provider Demographics
NPI:1205861051
Name:ALLERT, DEBBIE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:ANNE
Last Name:ALLERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:DEBBIE
Other - Middle Name:ANNE
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TWO HARBORS
Mailing Address - State:MN
Mailing Address - Zip Code:55616-1200
Mailing Address - Country:US
Mailing Address - Phone:218-834-7200
Mailing Address - Fax:218-834-7220
Practice Address - Street 1:1010 4TH ST
Practice Address - Street 2:
Practice Address - City:TWO HARBORS
Practice Address - State:MN
Practice Address - Zip Code:55616-1200
Practice Address - Country:US
Practice Address - Phone:218-834-7200
Practice Address - Fax:218-834-7220
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN32570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN686095800Medicaid
MN080015179Medicare PIN
MNE39852Medicare UPIN
MN686095800Medicaid
MN080015178Medicare PIN
MN080116128Medicare PIN