Provider Demographics
NPI:1477527489
Name:WARNER, DEBORAH ANNE (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:WARNER
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 1:1322 SAINT GOTTHARD AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5031
Mailing Address - Country:US
Mailing Address - Phone:907-240-6212
Mailing Address - Fax:907-929-4263
Practice Address - Street 1:1322 SAINT GOTTHARD AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5031
Practice Address - Country:US
Practice Address - Phone:907-929-4263
Practice Address - Fax:907-929-4267
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4211207Q00000X
AKAK4211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD4211Medicaid
151963Medicare ID - Type Unspecified
AKMD4211Medicaid