Provider Demographics
NPI:1477882447
Name:MYERS, DEBORAH S (BS, CI)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:MYERS
Suffix:
Gender:F
Credentials:BS, CI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 JONES RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04348-3312
Mailing Address - Country:US
Mailing Address - Phone:207-549-4733
Mailing Address - Fax:
Practice Address - Street 1:15 JONES RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04348-3312
Practice Address - Country:US
Practice Address - Phone:207-549-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist