Provider Demographics
NPI:1376580969
Name:PROTHROW-STITH, DEBORAH B (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:PROTHROW-STITH
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 1:841 PARKER ST., GROUND FLOOR
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:617-495-7777
Mailing Address - Fax:
Practice Address - Street 1:841 PARKER STREET, GROUND FLOOR
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-495-7777
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA476572083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine