Provider Demographics
NPI:1275616476
Name:FAIRCHILD HARDING, DEBORAH (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:FAIRCHILD HARDING
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 1:7575 DR. PHILLIPS BLVD.
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-345-1551
Mailing Address - Fax:407-345-4893
Practice Address - Street 1:7575 DR PHILLIPS BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7216
Practice Address - Country:US
Practice Address - Phone:407-345-1551
Practice Address - Fax:407-345-4893
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME046440207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME46440OtherMEDICAL LICENSE NUMBER
FLME46440OtherMEDICAL LICENSE NUMBER
FL02693Medicare ID - Type UnspecifiedPRIMARY MEDICARE NUMBER
FL02693ZMedicare ID - Type UnspecifiedPAR TO SAND LAKE MEDICAL