Provider Demographics
NPI:1467437442
Name:FOLEY, DEBORAH D (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:FOLEY
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 1:5622 BLACKFOOT TRL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-2386
Mailing Address - Country:US
Mailing Address - Phone:719-661-7019
Mailing Address - Fax:
Practice Address - Street 1:12930 WORLDGATE DR STE 300
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-6032
Practice Address - Country:US
Practice Address - Phone:703-657-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070125A208000000X
CO42707208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801615Medicare PIN
COD46940Medicare UPIN