Provider Demographics
NPI:1437151461
Name:GAMA LIMA, DEBORA M (MD)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:M
Last Name:GAMA LIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:15600 N BLACK CANYON HWY
Mailing Address - Street 2:SUITE 102-C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4055
Mailing Address - Country:US
Mailing Address - Phone:602-995-0822
Mailing Address - Fax:602-995-0825
Practice Address - Street 1:3811 E BELL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2138
Practice Address - Country:US
Practice Address - Phone:602-995-0822
Practice Address - Fax:602-995-0825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ31899208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ859085Medicaid
AZH69236Medicare UPIN
AZ859085Medicaid